Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 251854 | NY |
NPI | 1376795658 |
---|---|
Provider Name | Dr. Dara R Liotta |
First Address | New York, NY 10022-1304 |
Second Address | New York, NY 10022-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2008 |
Last Update Date | 16/02/2012 |