Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.200366 | LA |
N | 2080P0210X | Pediatric Nephrologist | 200366 | LA |
Y | 2080P0210X | Pediatric Nephrologist | 269053 | NY |
NPI | 1144411133 |
---|---|
Provider Name | Dr. Caroline E Straatmann |
First Address | Bronx, NY 10467-2401 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 15/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1074969 | (05) | LA |