Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0611993 | NY |
NPI | 1083270441 |
---|---|
Provider Name | Priyanka Ami Patel |
First Address | White Plains, NY 10606-4607 |
Second Address | Scarsdale, NY 10583-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2019 |
Last Update Date | 27/09/2021 |