Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 60-256435 | NY |
Y | 2080P0204X | Pediatric Emergency Doctor | 60-256435 | NY |
NPI | 1043231939 |
---|---|
Provider Name | Kathleen Doobinin |
First Address | Stony Brook, NY 11790-0989 |
Second Address | Stony Brook, NY 11794-8111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 21/05/2015 |