Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 197443 | NY |
NPI | 1124105036 |
---|---|
Provider Name | Florence Pua |
First Address | Bronx, NY 10458-1000 |
Second Address | Bronx, NY 10453-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 29/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F93538 | (02) | NY |