Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0116029317 | VA |
Y | 2080P0210X | Pediatric Nephrologist | OT020045 | PA |
NPI | 1518316652 |
---|---|
Provider Name | Rosanna Fulchiero |
First Address | Falls Church, VA 22042-3307 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2016 |
Last Update Date | 29/01/2021 |