Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 209210 | NY |
NPI | 1396849717 |
---|---|
Provider Name | Renee M Moadel |
First Address | Great Neck, NY 11021-2806 |
Second Address | Bronx, NY 10461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |