Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 304240 | NY |
NPI | 1023136959 |
---|---|
Provider Name | Ms. Irma Noriega |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10021-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 12/01/2012 |