Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 19943 | ZZ |
Y | 2080P0216X | Pediatric Rheumatologist | 003039 | NY |
NPI | 1417109521 |
---|---|
Provider Name | Dr. Emma Jane Macdermott |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |