Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 267706 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | MD428132 | PA |
NPI | 1104016823 |
---|---|
Provider Name | Sheila Nolan |
First Address | Hawthorne, NY 10532-2144 |
Second Address | Hawthorne, NY 10532-2144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 04/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03120692 | (05) | NY |
A400084747 | MEDICARE PTAN (01) | NY |
A400084748 | MEDICARE PTAN (01) | NY |