Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 25MA07843300 | NJ |
Y | 208000000X | Pediatrician | 215496 | NY |
NPI | 1437233921 |
---|---|
Provider Name | Dr. Munirih Nura Tahzib |
First Address | Uniondale, NY 11556-1301 |
Second Address | New York, NY 10010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 24/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H79690 | (02) |