Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 250930-1 | NY |
NPI | 1326026220 |
---|---|
Provider Name | Gina A Taylor |
First Address | Brooklyn, NY 11215-5010 |
Second Address | Brooklyn, NY 11203-2056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 13/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02724463 | (05) | NY |
I49958 | (02) | NY |