Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | F380595-1 | NY |
NPI | 1013098425 |
---|---|
Provider Name | Melinda A. Lando |
First Address | Bronx, NY 10452-6901 |
Second Address | Bronx, NY 10452-6901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02349508 | (05) | NY |