Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD008950E | PA |
NPI | 1124364294 |
---|---|
Provider Name | Margaret Mary Libonati |
First Address | New Tripoli, PA 18066-0224 |
Second Address | New Tripoli, PA 18066-0224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2012 |
Last Update Date | 18/12/2012 |