Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 21789 | MA |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 058399 | NY |
NPI | 1366588717 |
---|---|
Provider Name | Dr. Tania Jhamb |
First Address | Rochester, NY 14620-2913 |
Second Address | Rochester, NY 14620-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 07/02/2018 |