Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 050664 | NY |
NPI | 1053614263 |
---|---|
Provider Name | Dr. Bahn Yah Moon |
First Address | New York, NY 10065-8015 |
Second Address | New York, NY 10065-8015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2010 |
Last Update Date | 09/12/2010 |