Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | MD054226L | PA |
N | 207RH0003X | Hematology & Oncology | MD054226L | PA |
Y | 207RH0003X | Hematology & Oncology | MD16548 | RI |
NPI | 1275575714 |
---|---|
Provider Name | Wafik El Deiry |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 07/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014975600001 | (05) | PA |
F05523 | (02) |