Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 350500 | NY |
NPI | 1215557590 |
---|---|
Provider Name | Ms. Christie Marie Traynor |
First Address | Bay Shore, NY 11706-4055 |
Second Address | New Hyde Park, NY 11040-1433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2020 |
Last Update Date | 24/09/2020 |