Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 060545 | NY |
NPI | 1003306184 |
---|---|
Provider Name | Dr. Michelle Miriam Navi |
First Address | Jamaica, NY 11418-2619 |
Second Address | Jamaica, NY 11418-2619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2018 |
Last Update Date | 23/08/2019 |