Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 304009 | NY |
NPI | 1770945743 |
---|---|
Provider Name | Cassie Susan Mintz |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 17/04/2020 |