Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD453278 | PA |
NPI | 1003971060 |
---|---|
Provider Name | Rebecca Phaeton |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 02/01/2017 |