Doctor Name: | DR. STEPHANIE CONCEPCION |
NPI Number: | 1114137510 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 12720 |
Business Practice Address: | Carr #2 Km 141.1 Ave Kennedy Aguadilla, PR - 00603 |
Business Phone Number: | 7876580000 |
Business Fax Number: | |
Mailing Address: | 2053 Ave Pedro Albizu Campos, Ste 2 Pmb 146 AGUADILLA |
State: | PR |
Postal Code: | 006035950 |
Phone Number: | 7879349283 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12720 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |