Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086X0206X | Surgical Oncologist | 298722 | NY |
Y | 2086X0206X | Surgical Oncologist | TP279 | KY |
NPI | 1265842991 |
---|---|
Provider Name | Dr. Irada Ibrahim-Zada |
First Address | Buffalo, NY 14263-0001 |
Second Address | Edgewood, KY 41017-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2014 |
Last Update Date | 31/08/2021 |