Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD425217 | PA |
NPI | 1013932169 |
---|---|
Provider Name | Soraya E Jimenez |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I03120 | (02) |