Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 003618 | NY |
NPI | 1114137536 |
---|---|
Provider Name | Dr. Johanna Echavez Calo |
First Address | Goshen, NY 10924 |
Second Address | Valhalla, NY 10595-1652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 22/07/2010 |