Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | OS021208 | PA |
NPI | 1083091789 |
---|---|
Provider Name | Iwona Dziewa |
First Address | Glendale, NY 11385-6048 |
Second Address | Bethlehem, PA 18020-8037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2015 |
Last Update Date | 24/06/2021 |