Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 023436-1 | NY |
NPI | 1073050936 |
---|---|
Provider Name | Chelsea Boltja |
First Address | New York, NY 10019-5923 |
Second Address | New York, NY 10019-5923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2017 |
Last Update Date | 05/03/2021 |