Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N005871-1 | NY |
NPI | 1467513796 |
---|---|
Provider Name | Dr. Dina Tsentserensky |
First Address | Fort Lee, NJ 07024-4051 |
Second Address | New York, NY 10038-4811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U92414 | (02) | NY |