Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 337816 | NY |
NPI | 1003159286 |
---|---|
Provider Name | Mrs. Celia Engelson |
First Address | New York, NY 10017-6739 |
Second Address | New York, NY 10017-6739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 26/03/2021 |