Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F335140 | NY |
NPI | 1003034398 |
---|---|
Provider Name | Ms. Misty L Chiu |
First Address | Yonkers, NY 10703 |
Second Address | Yonkers, NY 10703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 17/09/2013 |