Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 310214 | NY |
NPI | 1669619813 |
---|---|
Provider Name | Dr. Mariko Marium Yabe-Gill |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2009 |
Last Update Date | 01/07/2021 |