Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 196020 | NY |
NPI | 1710925276 |
---|---|
Provider Name | Ayesa N Mian |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 22/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2925533 | (05) | NY |
775603800 | (05) | MD |
G73536 | (02) |