Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 216127 | NY |
NPI | 1003873290 |
---|---|
Provider Name | Dr. Deborah K Duello |
First Address | Massena, NY 13662-1437 |
Second Address | Massena, NY 13662-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02057427 | (05) | NY |
C50585 | (02) |