Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 298649 | NY |
N | 111NI0900X | Internist | 298649 | NY |
Y | 207RH0000X | Hematologist | 298649 | NY |
NPI | 1467897967 |
---|---|
Provider Name | Miss Layla Nohelia Van Doren |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2013 |
Last Update Date | 30/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LVD3232267556 | LVD3232267556 (01) | CA |