Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 268021 | NY |
NPI | 1013340918 |
---|---|
Provider Name | Dr. Kimberly Deanna Craven |
First Address | Brooklyn, NY 11203-2012 |
Second Address | Brooklyn, NY 11203-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 15/08/2013 |