Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35. 091188 | OH |
N | 208000000X | Pediatrician | MD452613 | PA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD452613 | PA |
NPI | 1164689055 |
---|---|
Provider Name | Girmay Haile Tekleyohannes |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 26/08/2020 |