Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 185493 | NY |
NPI | 1376520502 |
---|---|
Provider Name | Chaitanya R Divgi |
First Address | New York, NY 10032-3727 |
Second Address | New York, NY 10032-3727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E94690 | (02) |