Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | VP001919J | PA |
NPI | 1225299811 |
---|---|
Provider Name | Mrs. Susan Barbarossa |
First Address | Pittsburgh, PA 15224-1722 |
Second Address | Pittsburgh, PA 15224-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 17/06/2008 |