Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 128865 | NY |
N | 111NI0900X | Internist | 128865 | NY |
Y | 207RI0200X | Infectious Disease | 128865 | NY |
NPI | 1093750341 |
---|---|
Provider Name | Minou Absy-Jaghab |
First Address | East Meadow, NY 11554 |
Second Address | Bronx, NY 10451-5430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113465690 | ETIN 113465690 (01) | NY |
2154315 | UNITED EMPIRE (01) | NY |
4318302 | AETNA (01) | NY |