Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 146408 | NY |
NPI | 1245236207 |
---|---|
Provider Name | Dr. Kira Antonia Geraci-Ciardullo |
First Address | Mamaroneck, NY 10543-3151 |
Second Address | Mamaroneck, NY 10543-3151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 28/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B16471 | (02) | NY |