Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD451200 | PA |
NPI | 1003075946 |
---|---|
Provider Name | Lindsey E Cobbett |
First Address | Broomall, PA 19008-3518 |
Second Address | Broomall, PA 19008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 09/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04218948 | (05) | NY |
23-2359401 | MAIN LINE HEALTHCARE TAX ID (01) | PA |