Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X009569 | NY |
NPI | 1568792349 |
---|---|
Provider Name | Dr. Heather Pearman |
First Address | Pelham, NY 10803-1504 |
Second Address | Pelham, NY 10803-1504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2009 |
Last Update Date | 30/12/2009 |