Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD063945L | PA |
NPI | 1689603565 |
---|---|
Provider Name | Sarah Nicklin |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-8701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 21/06/2016 |