Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 395361 | NY |
NPI | 1043308281 |
---|---|
Provider Name | Michele Muldoon |
First Address | Warwick, NY 10990-1035 |
Second Address | West Nyack, NY 10994-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 29/08/2016 |