Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 042.0014140 | VT |
Y | 207VX0201X | Gynecologic Oncologist | 301841 | NY |
NPI | 1336464734 |
---|---|
Provider Name | Evelyn Cantillo |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10065-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 03/03/2021 |