Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 260729 | NY |
NPI | 1003071127 |
---|---|
Provider Name | Dr. Joanne Moreau |
First Address | Brooklyn, NY 11231-4334 |
Second Address | Brooklyn, NY 11231-4334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 19/09/2016 |