Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 081304-1 | NY |
NPI | 1003117235 |
---|---|
Provider Name | Mrs. Yesenia Cora-Buckner |
First Address | New York, NY 10029-6574 |
Second Address | New York, NY 10029-6574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2010 |
Last Update Date | 04/11/2010 |