Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 210206 | NY |
NPI | 1003035288 |
---|---|
Provider Name | Dr. Sadhana Bose |
First Address | Leonia, NJ 07605-1023 |
Second Address | Brooklyn, NY 11213-1122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H05681 | (02) |