Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 270477 | NY |
NPI | 1013209212 |
---|---|
Provider Name | Katherine Siamas |
First Address | New York, NY 10022-2384 |
Second Address | New York, NY 10022-2384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 24/09/2014 |