Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 043486 | NY |
NPI | 1104030147 |
---|---|
Provider Name | Dr. Gina Lodolini |
First Address | Mt Kisco, NY 10549 |
Second Address | Mt Kisco, NY 10549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |