Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD424142 | PA |
Y | 208600000X | Surgeon | MD424142 | PA |
N | 2086S0120X | Pediatric Surgery | MD424142 | PA |
NPI | 1225231947 |
---|---|
Provider Name | Kevin Mollen |
First Address | Lemoyne, PA 17043-1168 |
Second Address | Lemoyne, PA 17043-1168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 14/07/2021 |