Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 231561 | NY |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 231561 | NY |
NPI | 1205808904 |
---|---|
Provider Name | Marisa A Mastropietro |
First Address | New York, NY 10087-5453 |
Second Address | Brooklyn, NY 11215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02566329 | (05) | NY |
H51575 | (02) |