Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | SP022533 | PA |
NPI | 1225644107 |
---|---|
Provider Name | Emily Scaruzzi |
First Address | Philadelphia, PA 19122-4801 |
Second Address | Philadelphia, PA 19139-3232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2020 |
Last Update Date | 22/09/2020 |