Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD018382E | PA |
NPI | 1003952326 |
---|---|
Provider Name | Elizabeth Rock |
First Address | Phoenixville, PA 19460-0525 |
Second Address | Phoenixville, PA 19460-4478 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D68716 | (02) | PA |