Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD.206700 | LA |
NPI | 1386943579 |
---|---|
Provider Name | Jessica Aya Zagory |
First Address | New Orleans, LA 70118-5720 |
Second Address | New Orleans, LA 70112-2865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2011 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2151754 | (05) | LA |