Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 188898 | NY |
NPI | 1427267889 |
---|---|
Provider Name | Lorraine Chrisomalis Valasiadis |
First Address | New York, NY 10128-7650 |
Second Address | New York, NY 10128-7650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 25/07/2008 |