Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 197368 | NY |
NPI | 1447250287 |
---|---|
Provider Name | Mary Elizabeth Damore |
First Address | Hawthorne, NY 10532-1533 |
Second Address | Sleepy Hollow, NY 10591-1020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 08/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01856582 | (05) | NY |