Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F001200 | NY |
NPI | 1003954173 |
---|---|
Provider Name | Ms. Raquel Graciela Haynes |
First Address | Uniondale, NY 11553-2936 |
Second Address | Brooklyn, NY 11212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |