Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | P67426 | NY |
NPI | 1295974129 |
---|---|
Provider Name | Dr. Ruwadzano Chikosi |
First Address | Flushing, NY 11355-3769 |
Second Address | Flushing, NY 11355-5042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2009 |
Last Update Date | 17/02/2009 |