| NPI | 1669401022 |
|---|---|
| Former Name | POLLY J PECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303481) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 303481) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-07-07 |