Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 237136 | NY |
NPI | 1215014287 |
---|---|
Provider Name | Dr. Marcela Martha Vergara |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00246075 | (05) | NY |
H65964 | (02) | NY |