Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 301630 | NY |
NPI | 1023640448 |
---|---|
Provider Name | Dr. Leontine Julie Van Elden |
First Address | New York, NY 10025-6775 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2020 |
Last Update Date | 05/02/2020 |