Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 146287 | NY |
Y | 208600000X | Surgeon | 146287 | NY |
NPI | 1013095694 |
---|---|
Provider Name | Dr. Janis A Pastena |
First Address | Valhalla, NY 10595 |
Second Address | Valhalla, NY 10595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 19/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01223752 | (05) | NY |
C62900 | (02) | NY |