Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 240198 | NY |
NPI | 1992863146 |
---|---|
Provider Name | Dr. Gabriele Selma De Vos |
First Address | Bronx, NY 10469-5605 |
Second Address | Bronx, NY 10469-5605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02718385 | (05) | NY |