Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD453015 | PA |
NPI | 1003861006 |
---|---|
Provider Name | Joy C Drass |
First Address | Danville, PA 17822-4903 |
Second Address | Port Matilda, PA 16870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 31/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102981126 | (05) | PA |