Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 159060 | NY |
NPI | 1023067535 |
---|---|
Provider Name | Barbara M Hisler |
First Address | Hew Hyde Park, NY 11040 |
Second Address | Hew Hyde Park, NY 11040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 10/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01079189 | (05) | NY |
E41135 | (02) |