Doctor Name: | AMBILY PAILO |
NPI Number: | 1043664246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | SP016094 |
Business Practice Address: | 1205 Langhorne Newtown Rd Suite 309 Langhorne, PA - 190471219 |
Business Phone Number: | 2157411963 |
Business Fax Number: | |
Mailing Address: | 2624 Buffalo Ave, FEASTERVILLE TREVOSE |
State: | PA |
Postal Code: | 190536706 |
Phone Number: | 2674718726 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2016 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | SP016094 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |