Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N003917 | NY |
Y | 222Z00000X | Podiatrist | N003917 | NY |
NPI | 1053418061 |
---|---|
Provider Name | Dr. Barbara Lois Czeisler |
First Address | Commack, NY 11725-3009 |
Second Address | Commack, NY 11725-3009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31736 | (02) | NY |