Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | MD052227L | PA |
NPI | 1154329035 |
---|---|
Provider Name | Nancy House |
First Address | Pittsburgh, PA 15212-4756 |
Second Address | Sewickley, PA 15143-1535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F79057 | (02) | PA |