Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 43430484 | NY |
NPI | 1013231703 |
---|---|
Provider Name | Laurita Hidalgo |
First Address | Astoria, NY 11106-1211 |
Second Address | Astoria, NY 11106-1211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2010 |
Last Update Date | 24/03/2010 |