Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | OS006494L | PA |
NPI | 1700863743 |
---|---|
Provider Name | Raphael Gabay |
First Address | Philadelphia, PA 19115 |
Second Address | Philadelphia, PA 19115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013969240004 | (05) | PA |
F46857 | (02) |