Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD014281E | PA |
NPI | 1588603559 |
---|---|
Provider Name | Leonore Charles Huppert |
First Address | Philadelphia, PA 19107-6130 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 19/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052744000 | KEYSTONE HEALTH PLAN EAST (01) | PA |
025681 | PERSONAL CHOICE (01) | PA |
B33591 | (02) |