Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 32404 | AZ |
Y | 111NI0900X | Internist | 32404 | AZ |
N | 207RH0002X | Hospice and Palliative Medicine | 32404 | AZ |
NPI | 1093782625 |
---|---|
Provider Name | Monica Monidipa Banerjee |
First Address | Chandler, AZ 85246-7764 |
Second Address | Chandler, AZ 85225-7284 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 05/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F98328 | (02) |