Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 170643 | NY |
NPI | 1174603971 |
---|---|
Provider Name | Jenny Shliozberg |
First Address | Brooklyn, NY 11230-5103 |
Second Address | Brooklyn, NY 11230-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D46886 | (02) |