Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | ||
Y | 363LW0102X | Nurse Practitioner - Women's Health | 421390 | NY |
NPI | 1154971406 |
---|---|
Provider Name | Anna Larisa Lawyer Sunderland |
First Address | Brooklyn, NY 11216-5510 |
Second Address | Brooklyn, NY 11216-5510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2019 |
Last Update Date | 18/09/2019 |