Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | SP022777 | PA |
NPI | 1073874319 |
---|---|
Provider Name | Vivian Cino |
First Address | Hershey, PA 17033-0858 |
Second Address | Hollywood, FL 33021-5424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2012 |
Last Update Date | 30/11/2020 |