Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 050811-1 | NY |
NPI | 1922218023 |
---|---|
Provider Name | Dr. Nora A Odingo |
First Address | Stony Brook, NY 11794-8706 |
Second Address | Stony Brook, NY 11794-8705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 19/01/2010 |