Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 267313 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | 267313 | NY |
NPI | 1255537312 |
---|---|
Provider Name | Noelle Marie Coloma Javier |
First Address | New York, NY 10087-8082 |
Second Address | New York, NY 10029-6508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03604226 | (05) | NY |