Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 303593 | NY |
NPI | 1033152210 |
---|---|
Provider Name | Lynda Joyce Krasenbaum |
First Address | New York, NY 10021-2700 |
Second Address | New York, NY 10021-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P09501 | (02) |