Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 275916 | NY |
Y | 2080P0210X | Pediatric Nephrologist | 275916 | NY |
NPI | 1780855460 |
---|---|
Provider Name | Dr. Tanya Eva Pereira |
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 | 20/03/2008 |
Last Update Date | 04/08/2014 |