Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 198838 | NY |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 198838 | NY |
NPI | 1518074822 |
---|---|
Provider Name | Angela Damiano |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Ardsley, NY 10502-1045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01821181 | (05) | NY |
G59498 | (02) | NY |