Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD065930L | PA |
NPI | 1184620148 |
---|---|
Provider Name | Victoria M Sepesky |
First Address | Monessen, PA 15062-2210 |
Second Address | Monessen, PA 15062-1955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 26/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001729333 | (05) | PA |
G85383 | (02) | PA |