Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD417960 | PA |
NPI | 1013954643 |
---|---|
Provider Name | Lorraine C Snyder Dougherty |
First Address | Sellersville, PA 18960-1551 |
Second Address | Sellersville, PA 18960-1551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 16/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1018498710001 | (05) | PA |
H76284 | (02) |