Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | 791895971 | NY |
NPI | 1083998991 |
---|---|
Provider Name | Cheri Jamison |
First Address | New York, NY 10027-5443 |
Second Address | New York, NY 10044-0096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2011 |
Last Update Date | 11/10/2011 |