Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036118200 | IL |
N | 207VX0000X | Obstetrician | 248090 | NY |
NPI | 1205009628 |
---|---|
Provider Name | Dr. Komal Bajaj |
First Address | Bronx, NY 10461-1138 |
Second Address | Bronx, NY 10461-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2008 |
Last Update Date | 12/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
248090 | NYS MEDICAL LICENSE (01) | NY |