Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 161104 | NY |
NPI | 1093894149 |
---|---|
Provider Name | Esther Kissin |
First Address | Forest Hills, NY 11375-5266 |
Second Address | Forest Hills, NY 11375-5266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00914714 | (05) | NY |
B16249 | (02) | NY |