Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 320104 | NY |
NPI | 1811665789 |
---|---|
Provider Name | Danielle Mejias |
First Address | Binghamton, NY 13905 |
Second Address | Binghamton, NY 13903-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2021 |
Last Update Date | 03/09/2021 |