Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 022872 | NY |
NPI | 1013079086 |
---|---|
Provider Name | Hope Thyra Brady |
First Address | Hopewell Junction, NY 12533-7107 |
Second Address | Brooklyn, NY 11201-1144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 08/07/2007 |