Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 274346-112 | NY |
NPI | 1164650610 |
---|---|
Provider Name | Eleazar O'garro |
First Address | Potsdam, NY 13676-1786 |
Second Address | Potsdam, NY 13676-1889 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 31/03/2021 |