Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | 32087 | WI |
Y | 2080A0000X | Adolescent Medicine | MD12027 | ME |
NPI | 1124058151 |
---|---|
Provider Name | Paulette Y. Coty |
First Address | Bangor, ME 04402-1599 |
Second Address | Bangor, ME 04401-3016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 04/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E84164 | (02) |