Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F001207 | NY |
NPI | 1144417429 |
---|---|
Provider Name | Asya Portnaya |
First Address | Brooklyn, NY 11229-2303 |
Second Address | Brooklyn, NY 11229-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2007 |
Last Update Date | 01/10/2007 |