Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 055863 | NY |
N | 1223E0200X | Endodontist | 22DI0234910 | NJ |
NPI | 1134329071 |
---|---|
Provider Name | Dr. Trisha Charland |
First Address | New York, NY 10016-1201 |
Second Address | New York, NY 10016-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 16/11/2012 |