Gary, Ieshae Naticole /Latonya

Gary, Ieshae Naticole /Latonya is an individual health care provider with primary practice located at 5103 F St , Philadelphia PA 19124-3026. She recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as her primary health care specialty. Gary, Ieshae Naticole /Latonya can be contacted via phone (215) 687-6241.

Contact Information

Primary practice address
5103 F St Philadelphia PA 19124-3026
Phone: (215) 687-6241
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 55963601 Pennsylvania

Profile Details

NPI number 1932860020
LBN Legal business name Gary, Ieshae Naticole /Latonya
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 1st, 2022
Last updated Jan 1st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1932860020 NPPES
Pennsylvania MEDICAID 852473935

Popular Providers