Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 213692 | NY |
NPI | 1316949100 |
---|---|
Provider Name | Anna Zolotnitskaya |
First Address | Hawthorne, NY 10532-1533 |
Second Address | Hawthorne, NY 10532-1533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 23/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02270753 | (05) | NY |
H79003 | (02) | NY |