Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 250375 | NY |
NPI | 1033381983 |
---|---|
Provider Name | Na Ma |
First Address | Great Neck, NY 11024-1635 |
Second Address | Great Neck, NY 11024-1635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 27/08/2010 |