Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 173152 | NY |
NPI | 1073587325 |
---|---|
Provider Name | Kamini Shreedhar |
First Address | West Nyack, NY 10994-2226 |
Second Address | West Nyack, NY 10994-2221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01471489 | (05) | NY |
F27891 | (02) |