Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 021159 | NY |
NPI | 1033634084 |
---|---|
Provider Name | Kira Hettler |
First Address | West Chester, PA 19382-2058 |
Second Address | New York, NY 10065-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2017 |
Last Update Date | 11/08/2017 |