Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT203921 | PA |
Y | 2080P0214X | Pediatric Pulmonologist | MT203921 | PA |
NPI | 1407294606 |
---|---|
Provider Name | Julie Louise Fierro |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 27/06/2016 |