Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 242868-1 | NY |
NPI | 1134338122 |
---|---|
Provider Name | Khorsheda Begum Ali |
First Address | Peekskill, NY 10566-2913 |
Second Address | Monticello, NY 12701-2021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 19/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02900654 | (05) | NY |
AA0598 | MEDICARE GROUP (01) | NY |