Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 206856 | NY |
NPI | 1013098482 |
---|---|
Provider Name | Kathryn S Parker |
First Address | Shoreham, NY 11786-0722 |
Second Address | Bronx, NY 10457-7606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |