Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 054443-1 | NY |
NPI | 1003143207 |
---|---|
Provider Name | Dr. Tiana Hakimi |
First Address | Manhasset, NY 11030-3037 |
Second Address | Manhasset, NY 11030-3037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2009 |
Last Update Date | 10/10/2016 |