Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 156490 | NY |
NPI | 1063459030 |
---|---|
Provider Name | Julieta A Deguzman |
First Address | Garden City, NY 11530-2133 |
Second Address | South Richmond Hill, NY 11419-1412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A60394 | (02) | NY |