Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 137606 | NY |
NPI | 1023188539 |
---|---|
Provider Name | Dr. Sudha V Mukhi |
First Address | West Islip, NY 11795-4413 |
Second Address | West Islip, NY 11795-4413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 02/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00818575 | (05) | NY |
13D71100 | (02) | NY |