Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 174547 | NY |
NPI | 1457324915 |
---|---|
Provider Name | Katherine Economos |
First Address | New York, NY 10087-5453 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 23/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01439243 | (05) | NY |
F00087 | (02) |