Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F320046 | NY |
NPI | 1770538142 |
---|---|
Provider Name | Dr. Tina M Dalrymple |
First Address | Cooperstown, NY 13326-1301 |
Second Address | Morris, NY 13808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 03/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02439572 | (05) | NY |