Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD045968L | PA |
NPI | 1205836640 |
---|---|
Provider Name | Robert S Gorby |
First Address | Greensburg, PA 15601-2775 |
Second Address | Greensburg, PA 15601-2775 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 20/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015387160007 | (05) | PA |
G09703 | (02) | PA |