Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 231928 | NY |
N | 111NI0900X | Internist | 231928 | NY |
N | 207R00000X | Internist | 418839 | PA |
N | 111NI0900X | Internist | 418839 | PA |
Y | 207RA0201X | Internist - Allergy & Immunology | 418839 | PA |
N | 207RI0200X | Infectious Disease | 418839 | PA |
NPI | 1346336930 |
---|---|
Provider Name | Shirley M Fung |
First Address | Philadelphia, PA 19107-4398 |
Second Address | Philadelphia, PA 19107-4398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 30/12/2015 |