Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 218085 | NY |
N | 207RP1001X | Pulmonary Disease | 218085 | NY |
NPI | 1013084086 |
---|---|
Provider Name | Beata Edyta Popis-Matejak |
First Address | Old Greenwich, CT 06870-1339 |
Second Address | New York, NY 10029-7404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H19229 | (02) | NY |