Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 137080 | NY |
NPI | 1063571529 |
---|---|
Provider Name | Lina C Go |
First Address | New City, NY 10956-5550 |
Second Address | Bronx, NY 10451-5504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |