Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | ME136321 | FL |
NPI | 1285990515 |
---|---|
Provider Name | Nadya Telt |
First Address | Brooklyn, NY 11219-2916 |
Second Address | Tampa, FL 33607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 24/05/2018 |