Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 272636 | NY |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 62438 | CT |
NPI | 1326212523 |
---|---|
Provider Name | Dr. Heather Holmes Waters |
First Address | Flushing, NY 11355-5044 |
Second Address | Norwalk, CT 06851-1080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2008 |
Last Update Date | 24/06/2019 |