Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 293154 | NY |
NPI | 1275943219 |
---|---|
Provider Name | Katlynn Van Ogtrop |
First Address | Norwalk, CT 06850-3815 |
Second Address | Manhasset, NY 11030-3816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 10/03/2019 |