Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F420799-1 | NY |
NPI | 1013120674 |
---|---|
Provider Name | Ms. Theresa S Ciliberti |
First Address | New York, NY 10021-4866 |
Second Address | New York, NY 10021-4866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |