Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 124620 | NY |
N | 111NI0900X | Internist | 124620 | NY |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 124620 | NY |
NPI | 1033174263 |
---|---|
Provider Name | Adrienne Fleckman |
First Address | New York, NY 10003-3805 |
Second Address | New York, NY 10003-3805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 17/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01010342 | (05) | NY |
E69889 | (02) |