Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 060799 | NY |
NPI | 1043696610 |
---|---|
Provider Name | Nazanin Mohammadi-Tochaie |
First Address | Rochester, NY 14620-2913 |
Second Address | Rochester, NY 14620-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2015 |
Last Update Date | 12/02/2020 |