Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 241275-1 | NY |
NPI | 1285836379 |
---|---|
Provider Name | Dr. Rachelle Grace Gandica |
First Address | New York, NY 10032 |
Second Address | New York, NY 10032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 23/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03395113 | (05) | NY |
A400045971 | MEDICARE ID (01) | NY |