Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 302839 | NY |
NPI | 1043673445 |
---|---|
Provider Name | Dr. Taryn Huizenga |
First Address | New York, NY 10012-5801 |
Second Address | New York, NY 10012-5801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 17/01/2021 |