Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 055452-1 | NY |
NPI | 1063706430 |
---|---|
Provider Name | Dr. Soraya Chinea |
First Address | New York, NY 10010-4512 |
Second Address | Brooklyn, NY 11204-4903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 02/06/2011 |