Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 274493 | NY |
NPI | 1114339322 |
---|---|
Provider Name | Dr. Michelle Quan |
First Address | Brooklyn, NY 11201-5210 |
Second Address | Brooklyn, NY 11201-5210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 21/05/2014 |