Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MA058373 | NJ |
N | 2080P0204X | Pediatric Emergency Doctor | 35.133876 | OH |
NPI | 1053356048 |
---|---|
Provider Name | Dr. Leah Raguindin |
First Address | Hackensack, NJ 07601-2114 |
Second Address | Hackensack, NJ 07601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 23/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0287278 | (05) | OH |
G08905 | (02) | NJ |