Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 114891 | NY |
NPI | 1003972944 |
---|---|
Provider Name | Marguerite M Mayers |
First Address | Bronx, NY 10467 |
Second Address | Bronx, NY 10467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 11/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00928996 | (05) | NY |
B07934 | (02) |