Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 039231 | CT |
N | 208600000X | Surgeon | 039231 | CT |
N | 208200000X | Surgeon | 25MA08874200 | NJ |
N | 208600000X | Surgeon | 25MA08874200 | NJ |
Y | 208200000X | Surgeon | MD436759 | PA |
Y | 208600000X | Surgeon | MD436759 | PA |
NPI | 1023014230 |
---|---|
Provider Name | Malini Iyer |
First Address | Southampton, PA 18966-3829 |
Second Address | Southampton, PA 18966-3829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 13/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03367502 | AMERIGROUP (01) | NJ |
1400299 | COVENTRY (01) | NJ |
2400692 | CIGNA (01) | FL |
60174432 | HORIZON NJ HEALTH (01) | NJ |
7906347 | AETNA (01) | FL |
P01604147 | RR MEDICARE (01) | NJ |
P5369907 | UNTIED (01) | NJ |