Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | OS009133L | PA |
NPI | 1487650214 |
---|---|
Provider Name | John J Orris |
First Address | Bryn Mawr, PA 19010-3121 |
Second Address | Bryn Mawr, PA 19010-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01554 | (02) | PA |