Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 254888 | NY |
NPI | 1033347182 |
---|---|
Provider Name | Prabha Pillai |
First Address | Melville, NY 11747 |
Second Address | Commack, NY 11725-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 10/10/2014 |