Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD045307E | PA |
NPI | 1598778003 |
---|---|
Provider Name | Thomas V Whalen JR. |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 07/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E53178 | (02) |