Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA07841100 | NJ |
N | 208000000X | Pediatrician | D59551 | MD |
N | 208000000X | Pediatrician | DR47250 | CO |
N | 208000000X | Pediatrician | MD420340 | PA |
N | 208000000X | Pediatrician | MD42069 | WA |
Y | 2080P0208X | Pediatric Infectious Diseases | 278247 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 35.097468 | OH |
N | 2080P0208X | Pediatric Infectious Diseases | DR.0047250 | CO |
NPI | 1619012457 |
---|---|
Provider Name | Dr. Alice Isome Sato |
First Address | Albany, NY 12208-3795 |
Second Address | Denver, CO 80205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 15/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0055417 | (05) | OH |
07531885 | (05) | CO |
AB32999 | MEDICARE PTAN (01) | WA |