Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 10962 | CT |
N | 122300000X | Dentist | 22DI02544400 | NJ |
NPI | 1003255084 |
---|---|
Provider Name | Dr. Ishrat Rangwala |
First Address | Westfield, NJ 07090-1776 |
Second Address | Greenwich, CT 06830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2013 |
Last Update Date | 17/03/2018 |