Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 058897 | NY |
NPI | 1497199509 |
---|---|
Provider Name | Dr. Arthi Muthu Kumar |
First Address | Great Neck, NY 11023-1403 |
Second Address | Great Neck, NY 11023-1403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 19/05/2017 |