Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 014181 | NY |
NPI | 1336165356 |
---|---|
Provider Name | Mrs. Kristin M Englerth |
First Address | Stafford, NY 14143-9555 |
Second Address | Stafford, NY 14143-9555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164893GG | PREFERRED CARE INS. (01) | NY |
201687124-02 | UNIVERA HEALTH INSURANCE (01) | NY |