Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 153247 | NY |
NPI | 1043393523 |
---|---|
Provider Name | Dr. Mary Kathleen Reed |
First Address | Port Jefferson Station, NY 11776-8054 |
Second Address | Flushing, NY 11358-1641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 19/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E39102 | (02) | NY |