Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD061958L | PA |
N | 2081P2900X | Pain Medicine | MD061958L | PA |
NPI | 1164486155 |
---|---|
Provider Name | Gregory G Billy |
First Address | Hershey, PA 17033-0854 |
Second Address | State College, PA 16803-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 18/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016602300007 | (05) | PA |
G55396 | (02) |