Individual
SUSAN MAUREEN DUBENDORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 S 9TH ST, PHILADELPHIA, PA 19107-5233
(215) 206-9392
Mailing address
130 S 9TH ST, PHILADELPHIA, PA 19107-5233
(215) 206-9392
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA002833L
PA
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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