Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | OS016575 | PA |
NPI | 1174843528 |
---|---|
Provider Name | Michelle Anne Noreski |
First Address | Philadelphia, PA 19140-5103 |
Second Address | Philadelphia, PA 19140-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 23/07/2014 |