Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 05008482L | PA |
Y | 207RP1001X | Pulmonary Disease | 05008482L | PA |
NPI | 1003834581 |
---|---|
Provider Name | Joseph Guererri Crocetti JR. |
First Address | Abington, PA 19001-3840 |
Second Address | Abington, PA 19001-3840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 29/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017539740005 | (05) | PA |
G94577 | (02) |