Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X007602 | NY |
NPI | 1467548354 |
---|---|
Provider Name | Dr. Michelle Pfeffer |
First Address | Garden City, NY 11530-0037 |
Second Address | Levittown, NY 11756-3707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113570494 | TAX ID# (01) | NY |
2591469 | CIGNA (01) | NY |
324325 | ACN (01) | NY |
3367589 | AETNA (01) | NY |
4578840001 | NATIONAL HERITAGE INSURAN (01) | NY |
P2198024 | OXFORD (01) | NY |
U58327 | (02) | NY |