Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301085885 | MI |
Y | 207V00000X | Obstetrician & Gynecologist | MD2009-0223 | NM |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 267923 | NY |
NPI | 1356531883 |
---|---|
Provider Name | Dr. Mamta M. Mamik |
First Address | Bronx, NY 10461-1119 |
Second Address | Bronx, NY 10461-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2007 |
Last Update Date | 07/11/2019 |