Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | F382603-1 | NY |
NPI | 1013390376 |
---|---|
Provider Name | Hana Conlon |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-4707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2015 |
Last Update Date | 24/05/2016 |