Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 732444 | NY |
NPI | 1083367296 |
---|---|
Provider Name | Kylie O'connor |
First Address | Brooklyn, NY 11215-3999 |
Second Address | Brooklyn, NY 11220-3599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2022 |
Last Update Date | 28/01/2022 |