Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 38024 | AZ |
Y | 207VX0201X | Gynecologic Oncologist | MD11708 | RI |
NPI | 1578506820 |
---|---|
Provider Name | Dr. Christina Bandera |
First Address | Providence, RI 02905-4513 |
Second Address | Providence, RI 02904-2609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 28/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
313268 | (05) | AZ |
86080015085054 C001 | TRICARE (01) | AZ |
G07896 | (02) | |
P00623760 | RAILROAD MEDICARE (01) | AZ |