Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 13747 | PR |
Y | 208000000X | Pediatrician | 72021 | GA |
NPI | 1013093715 |
---|---|
Provider Name | Dr. Hilda T. Irizarry |
First Address | Fort Stewart, GA 31314-5641 |
Second Address | Fort Stewart, GA 31314-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 14/03/2019 |