Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 278195 | NY |
NPI | 1063613719 |
---|---|
Provider Name | Manju Alex |
First Address | Williamsville, NY 14221-8235 |
Second Address | Williamsville, NY 14221-8243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 10/07/2019 |