Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 050970 | NY |
N | 213EG0000X | General Practice | 050970 | NY |
Y | 1223G0001X | General Practice | DN23195 | FL |
Y | 213EG0000X | General Practice | DN23195 | FL |
NPI | 1003879255 |
---|---|
Provider Name | Dr. Geniretta Arakelova |
First Address | Boca Raton, FL 33486 |
Second Address | Boca Raton, FL 33433-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02553973 | (05) | NY |