Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 225524 | MA |
N | 111NI0900X | Internist | 225524 | MA |
Y | 207RG0100X | Gastroenterologist | 35.098020 | OH |
NPI | 1043492895 |
---|---|
Provider Name | Priya Mulgaokar Roy |
First Address | Columbus, OH 43202-1523 |
Second Address | Columbus, OH 43213-2174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2007 |
Last Update Date | 28/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0055414 | (05) | OH |