Individual
EVGENIA RAYELLE NOKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(251) 229-0409
Mailing address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-5726
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OT021111
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
OT021111
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/03/2021
Last updated
06/15/2021
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