Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 291502 | NY |
N | 111NI0900X | Internist | 291502 | NY |
Y | 207SG0201X | Clinical Genetics (M.D.) | 291502 | NY |
NPI | 1275927709 |
---|---|
Provider Name | Ayuko Iverson |
First Address | New York, NY 10017-5699 |
Second Address | New York, NY 10029-5204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 11/09/2019 |