Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0131X | Foot Surgery | 000800 | CT |
Y | 213ES0131X | Foot Surgery | 0317 | NH |
N | 213ES0131X | Foot Surgery | 25MD00283300 | NJ |
N | 213ES0131X | Foot Surgery | N005742 | NY |
NPI | 1356336614 |
---|---|
Provider Name | Ilana Itenberg |
First Address | Nashua, NH 03061-3677 |
Second Address | Nashua, NH 03060-3956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 17/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02459745 | (05) | NY |
06 | 1199 (01) | NY |
161658P | HIP (01) | NY |
2701877 | UNITED HEALTH CARE (01) | NY |
6298914 | GHI (01) | NY |
9533745 | CIGNA (01) | NY |
P3060948 | OXFORD (01) | NY |
PJ4082 | BCBS (01) | NY |
U95779 | (02) |