Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 38451 | NY |
NPI | 1073721353 |
---|---|
Provider Name | Dr. Amy Louise Ludwig |
First Address | New York, NY 10111-0100 |
Second Address | New York, NY 10111-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |