Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | C10010083 | DE |
Y | 207K00000X | Allergist & Immunologist | MD437762 | PA |
N | 208000000X | Pediatrician | 25MA08634500 | NJ |
N | 208000000X | Pediatrician | MD437762 | PA |
N | 2080N0001X | Neonatal-Perinatal Doctor | MD437762 | PA |
NPI | 1194854851 |
---|---|
Provider Name | Magee L. Defelice |
First Address | Rockland, DE 19723-0191 |
Second Address | Philadelphia, PA 19107-4824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 16/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102406939 0001 | (05) | PA |