Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00063200 | NJ |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 30 301188 | NY |
NPI | 1013176825 |
---|---|
Provider Name | Joanne Falletta Cregg |
First Address | New York, NY 10022-5243 |
Second Address | New York, NY 10022-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 06/06/2008 |