Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | F330800 | NY |
NPI | 1093883118 |
---|---|
Provider Name | Annastacia W Cowles |
First Address | Harris, NY 12742-0421 |
Second Address | Harris, NY 12742-0421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q44454 | (02) | NY |