Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MT184999 | PA |
NPI | 1023174034 |
---|---|
Provider Name | Kendrick Duldulao |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 08/07/2007 |