Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MT215581 | PA |
Y | 111NI0900X | Internist | MT215581 | PA |
NPI | 1003301722 |
---|---|
Provider Name | Jeri Charlotte Co Albano |
First Address | Philadelphia, PA 19141-3018 |
Second Address | Philadelphia, PA 19141-3018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 25/06/2018 |