Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 255895 | NY |
NPI | 1003011982 |
---|---|
Provider Name | Liliane Sarkis Deeb |
First Address | Staten Island, NY 10308-1606 |
Second Address | Staten Island, NY 10308-3335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 16/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03487010 | (05) | NY |