Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 041306 | NY |
NPI | 1003897455 |
---|---|
Provider Name | Dr. Ami Bhagat |
First Address | Hempstead, NY 11550 |
Second Address | Hempstead, NY 11550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01763799 | (05) | NY |