Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD037343E | PA |
NPI | 1003479825 |
---|---|
Provider Name | Marsha Frances Santangelo |
First Address | Blue Bell, PA 19422 |
Second Address | Blue Bell, PA 19422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 17/04/2019 |