Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 350128-1 | NY |
NPI | 1154894640 |
---|---|
Provider Name | Kathleen Patrice Maguire |
First Address | New York, NY 10128-1759 |
Second Address | New York, NY 10075-1850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2019 |
Last Update Date | 07/01/2019 |