Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F400897 | NY |
NPI | 1023138591 |
---|---|
Provider Name | Elizabeth Ann Vucic |
First Address | Poyntelle, PA 18454-0101 |
Second Address | New York, NY 10031-2036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 08/07/2007 |