Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 172652 | NY |
NPI | 1013057363 |
---|---|
Provider Name | Stacy Nunberg |
First Address | Pleasantville, NY 10570-1840 |
Second Address | Bronx, NY 10457-7606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |