Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 226389 | NY |
NPI | 1194751628 |
---|---|
Provider Name | Parul Bahl |
First Address | Hauppauge, NY 11788-9010 |
Second Address | West Islip, NY 11795-4927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 15/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02364441 | (05) | NY |