Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | F350-135-1 | NY |
NPI | 1356317119 |
---|---|
Provider Name | Joan Pasadino Brun0 |
First Address | Staten Island, NY 10312-3800 |
Second Address | Staten Island, NY 10305-3436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 04/06/2009 |