Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | Z18610 | NY |
NPI | 1003892134 |
---|---|
Provider Name | Nalini J Namassivaya |
First Address | Utica, NY 13502-2320 |
Second Address | Utica, NY 13502-2320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 12/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02087290 | (05) | NY |
G12351 | (02) |