Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N005096-1 | NY |
NPI | 1356645196 |
---|---|
Provider Name | Dr. Angela J Pollizzi-Varlotta |
First Address | Ny, NY 10016-4974 |
Second Address | New York, NY 10016-4974 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2011 |
Last Update Date | 10/01/2011 |