Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | SP007293 | PA |
NPI | 1043202815 |
---|---|
Provider Name | Marina Ordiner |
First Address | Narberth, PA 19072-1816 |
Second Address | Narberth, PA 19072-1816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 13/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1009671730001 | (05) | PA |
P66505 | (02) | PA |