Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101-050416 | VA |
N | 2080P0216X | Pediatric Rheumatologist | 0101-050416 | VA |
NPI | 1457323743 |
---|---|
Provider Name | Kathy Amoroso |
First Address | Roanoke, VA 24018-7895 |
Second Address | Roanoke, VA 24018-6438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 10/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006704280 | (05) | VA |
006708501 | (05) | VA |
E18139 | (02) | VA |