Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 204070-1 | NY |
N | 2080P0201X | Pediatric Allergist | 204070-1 | NY |
NPI | 1710989249 |
---|---|
Provider Name | Dr. Jocelyn Celestin |
First Address | Albany, NY 12203-5300 |
Second Address | Albany, NY 12205-5534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 25/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01716090 | (05) | NY |
F22625 | (02) | NY |