Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | D41419 | MD |
Y | 2080P0210X | Pediatric Nephrologist | MD438745 | PA |
NPI | 1295778850 |
---|---|
Provider Name | Susan Lynn Furth |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
650561900 | (05) | MD |
F65854 | (02) | MD |