Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 1239231 | NY |
NPI | 1003915687 |
---|---|
Provider Name | Dr. Usha C Wadhera |
First Address | Little Falls, NY 13365-1712 |
Second Address | Little Falls, NY 13365-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 30/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01021801 | (05) | NY |
B82944 | (02) |