Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | MD018446E | PA |
Y | 207VG0400X | Gynecologist | MD018446E | PA |
NPI | 1356433528 |
---|---|
Provider Name | Marianne Ruby |
First Address | Philadelphia, PA 19107-4306 |
Second Address | Philadelphia, PA 19107-4306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 14/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D68045 | (02) | PA |