Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 247505 | NY |
NPI | 1073783486 |
---|---|
Provider Name | Dr. Elizabeth Jane Haines |
First Address | New York, NY 10002-0000 |
Second Address | Brooklyn, NY 11220-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 09/04/2021 |