Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16909 | MD |
Y | 213EG0000X | General Practice | 16909 | MD |
N | 124Q00000X | Dental Hygienist | 023867-1 | NY |
NPI | 1003019829 |
---|---|
Provider Name | Dr. Mary Elizabeth Rondeau |
First Address | Tripler Amc, HI 96859-5001 |
Second Address | Bethesda, MD 20889-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 12/08/2019 |