Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 7568 | AZ |
NPI | 1124594205 |
---|---|
Provider Name | Caitlin Suriano |
First Address | Chandler, AZ 85224-5657 |
Second Address | Chandler, AZ 85224-5657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2018 |
Last Update Date | 12/11/2019 |