Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 262852 | NY |
N | 2080N0001X | Neonatal-Perinatal Doctor | 262852 | NY |
N | 2080P0205X | Pediatric Endocrinologist | 262852 | NY |
NPI | 1033367016 |
---|---|
Provider Name | Dr. Luisa Fernanda Lorena Edith Gonzalez Ballesteros |
First Address | New York, NY 10075-1851 |
Second Address | New York, NY 10075-1851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 15/10/2019 |