Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 332032 | NY |
NPI | 1003035320 |
---|---|
Provider Name | Denise Ayers |
First Address | Albany, NY 12208-3409 |
Second Address | Albany, NY 12208-3409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
332032 | (05) | NY |