Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 273664 | NY |
NPI | 1750654505 |
---|---|
Provider Name | Dr. Emily Ruth Dodwell |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021-4823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2012 |
Last Update Date | 18/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03432657 | (05) | NY |