Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MA060921 | PA |
NPI | 1023665460 |
---|---|
Provider Name | Tara Degnan |
First Address | Pittsburgh, PA 15241-2824 |
Second Address | Pittsburgh, PA 15215-3234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2019 |
Last Update Date | 21/08/2019 |