Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 016932 | NY |
NPI | 1033443585 |
---|---|
Provider Name | Tammy Vona |
First Address | Elmira, NY 14904-2709 |
Second Address | Elmira, NY 14904-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2009 |
Last Update Date | 30/09/2009 |