Provider Demographics
NPI:1922643519
Name:TAYLOR, EMMA STEPHANE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:STEPHANE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GIBRALTAR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2331
Mailing Address - Country:US
Mailing Address - Phone:215-675-1516
Mailing Address - Fax:
Practice Address - Street 1:201 GIBRALTAR RD STE 100
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2331
Practice Address - Country:US
Practice Address - Phone:215-675-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant