Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 43430547 | NY |
NPI | 1003110784 |
---|---|
Provider Name | Amy Pei Yun Vatanapradit |
First Address | New York, NY 10065 |
Second Address | New York, NY 10065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2011 |
Last Update Date | 15/10/2012 |