Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 049324 | NY |
NPI | 1154745602 |
---|---|
Provider Name | Maria Vinieris |
First Address | New City, NY 10956-1408 |
Second Address | New City, NY 10956-1408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2014 |
Last Update Date | 04/02/2014 |