Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 022530 | NY |
NPI | 1245712801 |
---|---|
Provider Name | Vicki Eliana Zucker |
First Address | New City, NY 10956 |
Second Address | Mineola, NY 11501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2018 |
Last Update Date | 30/08/2018 |