Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-128198 | OH |
Y | 2080A0000X | Adolescent Medicine | MD467779 | PA |
N | 2080P0204X | Pediatric Emergency Doctor | 35-128198 | OH |
NPI | 1235540782 |
---|---|
Provider Name | Rosemary Claire Roden |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2014 |
Last Update Date | 07/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103658019 | (05) | PA |