Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA08908400 | NJ |
NPI | 1053578534 |
---|---|
Provider Name | Marie M Camacho-Halili |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Bridgewater, NJ 08807-2560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 01/04/2019 |