Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | F350378-1 | NY |
NPI | 1053779678 |
---|---|
Provider Name | Miriam Schmalberg-Baum |
First Address | Brooklyn, NY 11213-5442 |
Second Address | Brooklyn, NY 11213-5442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2016 |
Last Update Date | 10/02/2016 |