Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 241074 | NY |
N | 2080P0201X | Pediatric Allergist | 241074 | NY |
NPI | 1700978681 |
---|---|
Provider Name | Dr. Ama Alexis |
First Address | New York, NY 10019-3158 |
Second Address | New York, NY 10019-3158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 09/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02805049 | (05) | NY |