Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L-247512 | MA |
N | 111NI0900X | Internist | L-247512 | MA |
Y | 207RP1001X | Pulmonary Disease | MD458343 | PA |
NPI | 1013203579 |
---|---|
Provider Name | Janae K Heath |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 21/02/2019 |