Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 181579 | NY |
NPI | 1003844309 |
---|---|
Provider Name | Karen Woodburn-Hourie |
First Address | New York, NY 10041-0004 |
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 | 28/06/2006 |
Last Update Date | 15/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01723615 | (05) | NY |
I64503 | (02) | NY |