Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | OS018926 | PA |
NPI | 1396185740 |
---|---|
Provider Name | Ms. Carolina Patricia Vasquez Prado |
First Address | West Reading, PA 19611-2143 |
Second Address | West Reading, PA 19611-2143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2013 |
Last Update Date | 12/03/2021 |