Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 188796 | NY |
NPI | 1013022805 |
---|---|
Provider Name | M Irene Vanderhoof |
First Address | Oneida, NY 13421-7111 |
Second Address | Oneida, NY 13421-7111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01487874 | (05) | NY |