Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 253286 | NY |
N | 207VX0201X | Gynecologic Oncologist | 25MB08307600 | NJ |
NPI | 1528269040 |
---|---|
Provider Name | Dr. Tana Shah Pradhan |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Hawthorne, NY 10532-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 21/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03460991 | (05) | NY |