Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 123966 | NY |
NPI | 1295980795 |
---|---|
Provider Name | Dr. Virginia Gerhart Soules |
First Address | New York, NY 10025-4803 |
Second Address | New York, NY 10025-4803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2008 |
Last Update Date | 25/11/2008 |