Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 25MA07828700 | NJ |
Y | 208200000X | Surgeon | 35.132238 | OH |
Y | 208600000X | Surgeon | 35.132238 | OH |
NPI | 1528099959 |
---|---|
Provider Name | Meelie Ashima Debroy |
First Address | Cleveland, OH 44106-1716 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0059251 | (05) | NJ |
H70764 | (02) |