Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 254944 | NY |
NPI | 1255640181 |
---|---|
Provider Name | Maria- Anna Vastardi |
First Address | Brooklyn, NY 11203-2012 |
Second Address | Brooklyn, NY 11228-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2010 |
Last Update Date | 13/11/2013 |