Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 232549 | NY |
NPI | 1609802479 |
---|---|
Provider Name | Monita Mendiratta |
First Address | Brooklyn, NY 11219-2919 |
Second Address | Brooklyn, NY 11219-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02591091 | (05) | NY |
I19639 | (02) | NY |