Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 006164 | NY |
NPI | 1083632681 |
---|---|
Provider Name | Dr. Tara Suzanne Richman-Driller |
First Address | New York, NY 10035-1815 |
Second Address | New York, NY 10035-1815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02838466 | (05) | NY |