Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 294343 | NY |
NPI | 1275913717 |
---|---|
Provider Name | Ellen Duncan |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2015 |
Last Update Date | 17/03/2021 |