Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 054583 | NY |
NPI | 1003142324 |
---|---|
Provider Name | Dr. Eleni Michaildiis |
First Address | New York, NY 10023-3356 |
Second Address | New York, NY 10023-3356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2009 |
Last Update Date | 21/10/2009 |