Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | F337729-1 | NY |
NPI | 1033545942 |
---|---|
Provider Name | Marta Sales |
First Address | Brooklyn, NY 11229 |
Second Address | Brooklyn, NY 11229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2013 |
Last Update Date | 24/09/2013 |