Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 104268 | NY |
NPI | 1578690129 |
---|---|
Provider Name | Dr. Dora Hammar Schively |
First Address | Millerton, NY 12546-4628 |
Second Address | New York, NY 10028-0112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |