Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 285305-1 | NY |
NPI | 1154687663 |
---|---|
Provider Name | Ms. Poroshat Shekarloo |
First Address | Brooklyn, NY 11219 |
Second Address | Brooklyn, NY 11228-3511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2012 |
Last Update Date | 22/11/2017 |