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General NPI Number Information
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NPI Number | 1548496326
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Entity Type | Individual
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Provider Name | MARIA J NIETO MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2009
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Last Update Date | 06/07/2009
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL # 1410
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City | NEW YORK
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State | NY
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Zip | 10029-6500
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Country | US
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Telephone | 212-241-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 182 E 95TH ST APT 7K
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City | NEW YORK
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State | NY
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Zip | 10128-2563
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Country | US
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Telephone | 212-348-3770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 236570
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License Number State | NY
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