Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 307117-01 | NY |
N | 2080P0207X | Pediatric Hematology-Oncologist | A162443 | CA |
NPI | 1104261502 |
---|---|
Provider Name | Katherine Clark Pehlivan |
First Address | Valhalla, NY 10595-1524 |
Second Address | Valhalla, NY 10595-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 13/11/2020 |