Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 286154 | NY |
NPI | 1689013450 |
---|---|
Provider Name | Mrs. Rhonda Lee Philopena |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2013 |
Last Update Date | 14/12/2017 |