Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 280795-1 | NY |
NPI | 1326278219 |
---|---|
Provider Name | Jorge Ernesto Mejia-Corletto |
First Address | North Babylon, NY 11703-1200 |
Second Address | North Babylon, NY 11703-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2009 |
Last Update Date | 15/03/2021 |