Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 2160131 | NY |
Y | 207VX0000X | Obstetrician | 2160131 | NY |
NPI | 1295952133 |
---|---|
Provider Name | Dr. Stella Mary Ebo |
First Address | Brooklyn, NY 11215-3609 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 29/02/2008 |