Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | SC001794L | PA |
NPI | 1164407086 |
---|---|
Provider Name | S Jerome Schnall |
First Address | Hermitage, PA 16148-1868 |
Second Address | Hermitage, PA 16148-1868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 23/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005044820 | (05) | PA |
T27735 | (02) | PA |