Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 155439 | NY |
NPI | 1366439937 |
---|---|
Provider Name | Sandra Scroggins |
First Address | Cohoes, NY 12047-5003 |
Second Address | Cohoes, NY 12047-5003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B83065 | (02) |