Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 213619 | NY |
NPI | 1104828862 |
---|---|
Provider Name | Abdul Haleem |
First Address | Valhalla, NY 10595-1652 |
Second Address | Valhalla, NY 10595-1646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 26/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02108134 | (05) | NY |
H61870 | (02) | NY |