Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 146719 | NY |
NPI | 1043380132 |
---|---|
Provider Name | Dr. Joan Kathy Berman |
First Address | New York, NY 10028-1068 |
Second Address | New York, NY 10028-1068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C06222 | (02) | NY |