Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 164162 | NY |
Y | 207V00000X | Obstetrician & Gynecologist | 164162-1 | NY |
NPI | 1003968512 |
---|---|
Provider Name | Mrs. Valerie M Muoio |
First Address | Great Neck, NY 11021 |
Second Address | Great Neck, NY 11021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 07/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01136236 | (05) | NY |
E36944 | (02) | NY |