Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 190860 | NY |
NPI | 1316980626 |
---|---|
Provider Name | Elizabeth J Haynes |
First Address | Jamaica, NY 11418 |
Second Address | Brooklyn, NY 11212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01789124 | (05) | NY |
F78999 | (02) |