Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 22164 | WV |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35087146 | OH |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD427007 | PA |
NPI | 1033182142 |
---|---|
Provider Name | Mary Kendall Rago |
First Address | Sewickley, PA 15143-1300 |
Second Address | Sewickley, PA 15143-1300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1018523020001 | (05) | PA |
2634706 | (05) | OH |
3810004695 | (05) | WV |
E59607 | (02) | OH |
P00289437 | RR MEDICARE (01) | OH |