Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS037793 | PA |
NPI | 1013150697 |
---|---|
Provider Name | Hongjiao Ouyang |
First Address | Pittsburgh, PA 15261-0001 |
Second Address | Pittsburgh, PA 15261-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2009 |
Last Update Date | 13/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DS037793 | STATE LICENSE (01) |