Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | RN399351 | OH |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN724709 | PA |
NPI | 1023404555 |
---|---|
Provider Name | Mrs. Elizabeth Ann Sano |
First Address | Media, PA 19063-3804 |
Second Address | Conshohocken, PA 19428-1180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 18/01/2022 |