Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 170380 | NY |
NPI | 1053701375 |
---|---|
Provider Name | Michele Pitale |
First Address | Harrison, NY 10528-1104 |
Second Address | Harrison, NY 10528-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2015 |
Last Update Date | 26/01/2015 |