NPI Profile for EBENEZER VANDER PALLEN in STATEN ISLAND, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nuclear Imaging & Therapy |
207UN0902X | 36 | Physician/Nuclear Medicine |
| NPI Number | 1760906143 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 07/27/2017 | |
| Last updated | 07/27/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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EBENEZER VANDER PALLEN
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