Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 242051 | NY |
NPI | 1013171859 |
---|---|
Provider Name | Kaniz Nilufar Banu |
First Address | Jamaica, NY 11432-2624 |
Second Address | Bronx, NY 10453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |