Basic Information
Provider Information
NPI: 1518216993
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ECHEVARRIA OYARZUN
FirstName: GHISLAINE
MiddleName: CAROLINA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5024
Address2:  
City: NEW YORK
State: NY
PostalCode: 100876504
CountryCode: US
TelephoneNumber: 8006274470
FaxNumber: 4129375710
Practice Location
Address1: 1000 10TH AVE RM 1G-33
Address2:  
City: NEW YORK
State: NY
PostalCode: 100191147
CountryCode: US
TelephoneNumber: 2125236121
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2012
LastUpdateDate: 08/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000X280452-1NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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