Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 001801 | NY |
N | 363LW0102X | Nurse Practitioner - Women's Health | 421306 | NY |
NPI | 1073032116 |
---|---|
Provider Name | Nicole Christine Primoff |
First Address | Brooklyn, NY 11226-4519 |
Second Address | Brooklyn, NY 11229-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2017 |
Last Update Date | 10/09/2017 |