Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 4233921 | NY |
N | 2080P0214X | Pediatric Pulmonologist | OS015115 | PA |
NPI | 1073825121 |
---|---|
Provider Name | Kelly Marie Adams |
First Address | Bronx, NY 10467-2403 |
Second Address | Bronx, NY 10467-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 29/08/2014 |