Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 245621 | NY |
Y | 2080A0000X | Adolescent Medicine | 245621-1 | NY |
NPI | 1659565919 |
---|---|
Provider Name | Dr. Mary B Deegan Haff |
First Address | Bellmore, NY 11710-2222 |
Second Address | Bellmore, NY 11710-2222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 01/12/2021 |