Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 042658-01 | PA |
NPI | 1043728645 |
---|---|
Provider Name | Alexandria Dsouza |
First Address | New York, NY 10018-9835 |
Second Address | New York, NY 10018-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2018 |
Last Update Date | 24/08/2020 |