Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | NOO5267 | NY |
NPI | 1295742716 |
---|---|
Provider Name | Tamira Vannoy |
First Address | Brooklyn, NY 11208-2812 |
Second Address | Brooklyn, NY 11208-2812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 14/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01692144 | (05) | NY |
U61975 | (02) |