Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N004863 | NY |
Y | 222Z00000X | Podiatrist | N004863 | NY |
NPI | 1033101837 |
---|---|
Provider Name | Joan Adler |
First Address | Johnson City, NY 13790-2558 |
Second Address | Binghamton, NY 13903-1651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 27/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01502698 | (05) | NY |
U44164 | (02) |