Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 078311 | NY |
NPI | 1023165743 |
---|---|
Provider Name | Charlotte Colp |
First Address | New York, NY 10021-3556 |
Second Address | New York, NY 10021-3556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B77618 | (02) | NY |