Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | F3037771 | NY |
NPI | 1083696249 |
---|---|
Provider Name | Dorothy Anne Kleinert |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10021-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 24/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q55036 | (02) | NY |