Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 216685 | NY |
NPI | 1194791814 |
---|---|
Provider Name | Dr. Elizabeth Roman |
First Address | New York, NY 10016-6004 |
Second Address | New York, NY 10016-6004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 29/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02711080 | (05) | NY |
I46035 | (02) | NY |