Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 260895 | NY |
NPI | 1023316429 |
---|---|
Provider Name | Chaneve Jeanniton |
First Address | Brooklyn, NY 11205-4007 |
Second Address | New York, NY 10003-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 30/07/2012 |