Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | DS0308646 | PA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | MD423518 | PA |
NPI | 1356379846 |
---|---|
Provider Name | Helen E Giannakopoulos |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 26/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018968140003 | (05) | PA |
U89800 | (02) |