Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 219377 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 219377 | NY |
NPI | 1114015484 |
---|---|
Provider Name | Patricia A. Delamora |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 14/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02677750 | (05) | NY |