Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 168279 | NY |
NPI | 1699872622 |
---|---|
Provider Name | Maria Tolete |
First Address | Hollis, NY 11423-1203 |
Second Address | Brooklyn, NY 11206-5317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |