Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 197743 | NY |
NPI | 1528066834 |
---|---|
Provider Name | Dr. Evelyn Tolston |
First Address | New York, NY 10016-5421 |
Second Address | New York, NY 10016-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01600839 | (05) | NY |
G15748 | (02) | NY |