Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD063599L | PA |
NPI | 1205969607 |
---|---|
Provider Name | Sandi Mae Vivienne See Tai |
First Address | Haddon Township, NJ 08108-2236 |
Second Address | Philadelphia, PA 19134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018649460001 | (05) | PA |
H53826 | (02) |