Provider Demographics
NPI:1770920761
Name:ERKOBONI-WILBUR, DANIELLE CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CHRISTINA
Last Name:ERKOBONI-WILBUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:ERKOBONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1340 DEKALB ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3434
Mailing Address - Country:US
Mailing Address - Phone:610-272-4550
Mailing Address - Fax:
Practice Address - Street 1:1340 DEKALB ST STE 4
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3434
Practice Address - Country:US
Practice Address - Phone:610-272-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457619208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032474340005Medicaid