Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD432036 | PA |
NPI | 1033303409 |
---|---|
Provider Name | Maria Ghetu |
First Address | Bethlehem, PA 18015-1000 |
Second Address | Bethlehem, PA 18017-4204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 08/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD432036 | LICENSE (01) | PA |