Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 134462 | NY |
NPI | 1720161367 |
---|---|
Provider Name | Dr. Gillian Mary Shepherd |
First Address | New York, NY 10021-6040 |
Second Address | New York, NY 10021-6040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B78262 | (02) | NY |