Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 036-078953 | IL |
NPI | 1356314058 |
---|---|
Provider Name | Ms. Jana Podzimek |
First Address | Auburn, NY 13021-1944 |
Second Address | New Hartford, NY 13413-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2006 |
Last Update Date | 26/08/2021 |