Individual
SUSAN GICHOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S 9TH ST, PHILADELPHIA, PA 19107-5125
(215) 592-4500
Mailing address
1500 MARKET ST, PHILADELPHIA, PA 19102-2100
(215) 985-2500
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN534619
PA
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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