Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 100064 | NY |
NPI | 1518223973 |
---|---|
Provider Name | Linell De-Silva Skeene |
First Address | New Hyde Park, NY 11040-2248 |
Second Address | New Hyde Park, NY 11040-2248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 10/04/2012 |