Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 244483 | NY |
NPI | 1164626388 |
---|---|
Provider Name | Liana R Yoder-Hegde |
First Address | Westhampton Beach, NY 11978-1401 |
Second Address | Westhampton Beach, NY 11978-1401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 03/12/2008 |