Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 115629 | NY |
N | 2080P0204X | Pediatric Emergency Doctor | 115629 | NY |
NPI | 1194815282 |
---|---|
Provider Name | Dr. Bangalore Rangaswamy Nagaroopa |
First Address | Valley Stream, NY 11581-2515 |
Second Address | Bronx, NY 10457-7626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 10/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00832471 | (05) | NY |
B88812 | (02) | NY |