Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 34.008888 | OH |
NPI | 1205055951 |
---|---|
Provider Name | Svetlana Lvovich |
First Address | Philadelphia, PA 19130-3952 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 13/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34.008822 | MEDICAL LICENSE (01) | OH |