Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 295181 | NY |
NPI | 1104346675 |
---|---|
Provider Name | Mrs. Eve Beaudry Simoneau |
First Address | New York, NY 10032 |
Second Address | New York, NY 10032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 01/11/2018 |