Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P11719 | NY |
Y | 222Z00000X | Podiatrist | P11719 | NY |
NPI | 1063999183 |
---|---|
Provider Name | Dr. Abinash Mishra |
First Address | Brooklyn, NY 11210-6236 |
Second Address | Brooklyn, NY 11210-6236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2018 |
Last Update Date | 21/07/2018 |