Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 285012 | NY |
N | 2080N0001X | Neonatal-Perinatal Doctor | 055460 | CT |
N | 2080N0001X | Neonatal-Perinatal Doctor | 285012 | NY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 35.131500 | OH |
NPI | 1013235597 |
---|---|
Provider Name | Dr. Loren Ann Nallu |
First Address | Bridgeport, CT 06610-2805 |
Second Address | Kettering, OH 45429-1221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 31/10/2018 |