Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 50852 | AZ |
Y | 2080P0208X | Pediatric Infectious Diseases | 50852 | AZ |
NPI | 1558685594 |
---|---|
Provider Name | Anthonia Manje Hananiya |
First Address | Phoenix, AZ 85008-4973 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2010 |
Last Update Date | 23/06/2015 |