Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | TRN12926 | FL |
Y | 2080P0205X | Pediatric Endocrinologist | 284885 | NY |
NPI | 1487949913 |
---|---|
Provider Name | Angela Patricia Mojica Sanabria |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 18/08/2016 |