Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 239331 | NY |
NPI | 1053579003 |
---|---|
Provider Name | Mina Pastagia |
First Address | Woodhaven, NY 11421-1724 |
Second Address | Woodhaven, NY 11421-1724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 27/05/2008 |