Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 228297 | NY |
NPI | 1417958109 |
---|---|
Provider Name | Mala Varma |
First Address | Philadelphia, PA 19195-2467 |
Second Address | New York, NY 10019-1147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 12/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02441358 | (05) | NY |
G72974 | (02) |