Didonato, Liezl Rasgo
Didonato, Liezl Rasgo is an individual health care provider with primary practice located at 111 S 11Th St Suite 6270, Philadelphia PA 19107-4824. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Didonato, Liezl Rasgo can be contacted via phone (215) 955-4912.Contact Information
Primary practice address
111 S 11Th St Suite 6270
Philadelphia PA 19107-4824
Phone: (215) 955-4912
Fax: (215) 923-0835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | SP012329 | Pennsylvania |
Profile Details
| NPI number | 1114343654 |
|---|---|
| LBN Legal business name | Didonato, Liezl Rasgo |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2014 |
| Last updated | Jul 22nd, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114343654 | NPPES |
| Pennsylvania | MEDICAID | 102925771 |
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