Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 230434 | NY |
Y | 111NI0900X | Internist | 230434 | NY |
N | 207RI0200X | Infectious Disease | 230434 | NY |
NPI | 1063457604 |
---|---|
Provider Name | Dr. Kinga Marta Riccobono |
First Address | New York, NY 10087-5051 |
Second Address | Garden City, NY 11530-2925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 21/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02801201 | (05) | NY |
155446 | (02) | NY |