Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 159564 | NY |
NPI | 1295820629 |
---|---|
Provider Name | Gladys Laroche |
First Address | Brooklyn, NY 11206 |
Second Address | Brooklyn, NY 11206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 28/07/2014 |