Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | F334890 | NY |
NPI | 1124106125 |
---|---|
Provider Name | Reine James |
First Address | Hauppauge, NY 11788-9010 |
Second Address | West Islip, NY 11795-4927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |