Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1043587728 |
---|---|
Provider Name | Angela Maria Salas |
First Address | Forest Hills, NY 11375-0537 |
Second Address | Rego Park, NY 11374-4716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2011 |
Last Update Date | 22/11/2011 |