Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 023096-1 | NY |
NPI | 1063689321 |
---|---|
Provider Name | Nafeesa King |
First Address | Hempstead, NY 11550-5203 |
Second Address | Brooklyn, NY 11201-1144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 14/05/2008 |