Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD464928 | PA |
NPI | 1013327915 |
---|---|
Provider Name | Sandra Birnbaum |
First Address | Basking Ridge, NJ 07920-1850 |
Second Address | Philadelphia, PA 19107-5127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2014 |
Last Update Date | 03/12/2018 |