Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | MD011868E | PA |
NPI | 1073802112 |
---|---|
Provider Name | Mrs. Elizabeth Guttman Sevin |
First Address | Penn Valley, PA 19072-1113 |
Second Address | Penn Valley, PA 19072-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2011 |
Last Update Date | 29/03/2011 |