Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 260204 | NY |
Y | 2080A0000X | Adolescent Medicine | 260204 | NY |
NPI | 1215237417 |
---|---|
Provider Name | Dr. Caroline Linda Salas-Humara |
First Address | Bronx, NY 10459-2417 |
Second Address | Bronx, NY 10459-2417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2010 |
Last Update Date | 29/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
260204 | LICENSE (01) | NY |