Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | OS004869L | PA |
NPI | 1073550257 |
---|---|
Provider Name | Ellen Miller |
First Address | Levittown, PA 19058-0538 |
Second Address | Langhorne, PA 19047-1753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 25/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010631400002 | (05) | PA |
E64194 | (02) | PA |