Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 230132 | NY |
NPI | 1215905161 |
---|---|
Provider Name | Erica Kreismann |
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 | 08/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I23129 | (02) | NY |