Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 231323 | NY |
NPI | 1528174091 |
---|---|
Provider Name | Dr. Allison Teresa Pontius |
First Address | New York, NY 10021-0258 |
Second Address | New York, NY 10021-0258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I09895 | (02) | NY |