Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 030563-E | PA |
NPI | 1003809815 |
---|---|
Provider Name | Sherry L Blumenthal |
First Address | Willow Grove, PA 19090-1041 |
Second Address | Willow Grove, PA 19090-1041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 17/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29594 | (02) | PA |