Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 048313 | NY |
Y | 213EG0000X | General Practice | 048313 | NY |
NPI | 1003902255 |
---|---|
Provider Name | Dr. Jennifer Aspen Wachs |
First Address | Yorktown Heights, NY 10598-4530 |
Second Address | Yorktown Heights, NY 10598-4530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |