Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 019729 | NY |
NPI | 1881028587 |
---|---|
Provider Name | Nicole French |
First Address | Bridgeport, NY 13030-9467 |
Second Address | Mattydale, NY 13211-1147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2013 |
Last Update Date | 29/08/2013 |