Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F342080-1 | NY |
NPI | 1003323312 |
---|---|
Provider Name | Ms. Mari Kashiwai Chen |
First Address | New York, NY 10019-3731 |
Second Address | New York, NY 10022-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 08/01/2018 |