Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 220708 | NY |
NPI | 1205876281 |
---|---|
Provider Name | Paula Marie Grimaldi |
First Address | White Plains, NY 10603-2403 |
Second Address | White Plains, NY 10603-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 20/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02365126 | (05) | NY |
H82198 | (02) | NY |