Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 132189 | NY |
NPI | 1063412872 |
---|---|
Provider Name | Indira Dasgupta |
First Address | Bronx, NY 10466-2604 |
Second Address | Bronx, NY 10466-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 26/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00728198 | (05) | NY |
B19268 | (02) | NY |