Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | F304503 | NY |
NPI | 1265556641 |
---|---|
Provider Name | Elizabeth Toledo |
First Address | Middletown, NY 10941-4028 |
Second Address | Middletown, NY 10941-4028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 13/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02860644 | (05) | NY |