Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 049963 | NY |
NPI | 1386701803 |
---|---|
Provider Name | Dr. Nathalie S Mohadjeri |
First Address | Brooklyn, NY 11220-2508 |
Second Address | Brooklyn, NY 11220-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/01/2013 |