Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD449225 | PA |
NPI | 1003129685 |
---|---|
Provider Name | Janna Prater |
First Address | Philadelphia, PA 19115-2185 |
Second Address | Philadelphia, PA 19115-2185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2010 |
Last Update Date | 31/07/2015 |