Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 194031 | NY |
N | 2080P0216X | Pediatric Rheumatologist | MD2016-004 | NM |
NPI | 1609878362 |
---|---|
Provider Name | Christine Hom |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 12/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01978918 | (05) | NY |
H18435 | (02) | NY |