Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A108817 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 265322-1 | NY |
NPI | 1083751184 |
---|---|
Provider Name | Cara Louise Grimes |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Hawthorne, NY 10532-2170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 02/12/2021 |