Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E10000236 | DE |
N | 222Z00000X | Podiatrist | E10000236 | DE |
Y | 213E00000X | Podiatrist | SC006510 | PA |
Y | 222Z00000X | Podiatrist | SC006510 | PA |
NPI | 1053751727 |
---|---|
Provider Name | Wendy Kim Le |
First Address | Kennett Square, PA 19348-1764 |
Second Address | Kennett Square, PA 19348-1764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 06/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
496086D0K | (02) | PA |
522133ZH5D | (02) | DE |