Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | N007151 | NY |
NPI | 1144718974 |
---|---|
Provider Name | Fabliha Masnoon Anbar |
First Address | Riverhead, NY 11901-2563 |
Second Address | Riverhead, NY 11901-2563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 28/09/2021 |