Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 77969 | GA |
NPI | 1477834398 |
---|---|
Provider Name | Jessica Esther Harroche |
First Address | Bronx, NY 10463-2247 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2011 |
Last Update Date | 28/05/2017 |