Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 278770-1 | NY |
NPI | 1003108184 |
---|---|
Provider Name | Dr. Heather A Posillico |
First Address | Mineola, NY 11501 |
Second Address | Mineola, NY 11501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2011 |
Last Update Date | 30/03/2021 |