Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 203614 | NY |
NPI | 1104955731 |
---|---|
Provider Name | Marie Brignol |
First Address | Forest Hills, NY 11375 |
Second Address | Forest Hills, NY 11375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |