Maira Fonseca
Dermatology in Bronx, NY. Individual provider (NPI-1).
NPI number1003201799
StatusActive
Last updated in NPPESNov 14, 2024
Details
- NPI
- 1003201799
- Entity type
- Individual (NPI-1)
- Name
- Maira Fonseca
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 31, 2015
- Certification date
- Nov 14, 2024
- Last updated
- Nov 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 300446 | NY | Yes |
Practice location
234 E 149th StBronx, NY 10451-5504
Phone 212-639-3210
Mailing address
1275 York Ave # 8New York, NY 10065-6007
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