Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 307780 | NY |
NPI | 1023565835 |
---|---|
Provider Name | Billie Radovic |
First Address | Sleepy Hollow, NY 10591-1075 |
Second Address | Sleepy Hollow, NY 10591-1076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 17/10/2019 |