Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 3330 | NY |
Y | 222Z00000X | Podiatrist | 3330 | NY |
NPI | 1992988364 |
---|---|
Provider Name | Dr. Deborah Marion Siegel |
First Address | Staten Island, NY 10309-3102 |
Second Address | Staten Island, NY 10309-3102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2007 |
Last Update Date | 08/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3330 | DPM LICENSE (01) | NY |