Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 292628 | NY |
NPI | 1366760282 |
---|---|
Provider Name | Jovana Yanique Martin |
First Address | Albany, NY 12208-1743 |
Second Address | Albany, NY 12208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2010 |
Last Update Date | 10/10/2019 |