Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 246075-1 | NY |
N | 207V00000X | Obstetrician & Gynecologist | 62506 | GA |
N | 207VX0201X | Gynecologic Oncologist | 25MA10142500 | NJ |
Y | 207VX0201X | Gynecologic Oncologist | 62506 | GA |
NPI | 1073751731 |
---|---|
Provider Name | Dr. Leda Portia Gattoc |
First Address | Atlanta, GA 30368-2321 |
Second Address | Atlanta, GA 30318-0921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 29/03/2021 |