Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 060849 | NY |
NPI | 1063864759 |
---|---|
Provider Name | Dr. Amrita Batheja |
First Address | Brooklyn, NY 11212-3139 |
Second Address | Brooklyn, NY 11212-3139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 08/04/2020 |