Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 140301 | NY |
NPI | 1053337204 |
---|---|
Provider Name | Lata D Bhansali |
First Address | White Plains, NY 10601-4803 |
Second Address | White Plains, NY 10601-4803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 26/09/2012 |