Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 006561 | NY |
NPI | 1093157869 |
---|---|
Provider Name | Dr. Miquetta L. Trimble |
First Address | New York, NY 10021-0047 |
Second Address | New York, NY 10001-7604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2013 |
Last Update Date | 12/08/2013 |