Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F303920 | NY |
NPI | 1003165374 |
---|---|
Provider Name | Amparo G Camacho |
First Address | New York, NY 10065-6007 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2012 |
Last Update Date | 30/07/2015 |