Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 183943 | NY |
NPI | 1720057979 |
---|---|
Provider Name | Dr. Miriam Norma Casal |
First Address | Jackson Heights, NY 11372 |
Second Address | Jackson Heights, NY 11372-6630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 15/06/2016 |