Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | E0015491 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 239197 | NY |
NPI | 1376524405 |
---|---|
Provider Name | Rabia Agha |
First Address | Brooklyn, NY 11219-2919 |
Second Address | Brooklyn, NY 11219-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 11/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02020473 | (05) | NY |
H61751 | (02) |