Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | P94461 | NY |
NPI | 1538566252 |
---|---|
Provider Name | Kailas Bhandarkar |
First Address | New York, NY 10021-2510 |
Second Address | New York, NY 10021-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2014 |
Last Update Date | 24/11/2014 |