Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 225628 | NY |
NPI | 1265489132 |
---|---|
Provider Name | Dr. Mirjana Maletic-Savatic |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-3456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02374216 | (05) | NY |
470N82 | EMPIRE BC/BS (01) | NY |
7678392 | AETNA (01) | NY |
I02393 | (02) | NY |