Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | AW2478091 | NY |
NPI | 1063434447 |
---|---|
Provider Name | Pauline A Walks-Akintobi |
First Address | Brooklyn, NY 11216-2607 |
Second Address | Newark, NJ 07104-4309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1235300799 | 37 N DAY (01) | NJ |
1932370483 | 444 WILLIAM STREET (01) | NJ |
1972778413 | 1150 SPRINGFIELD (01) | NJ |
5299608 | (05) | NJ |
E17253 | (02) | NY |