Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 300366 | NY |
NPI | 1881120376 |
---|---|
Provider Name | Yonina Mar |
First Address | New York, NY 10003 |
Second Address | New York, NY 10003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2017 |
Last Update Date | 16/10/2019 |