Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 104435 | MN |
N | 208000000X | Pediatrician | 52155 | MN |
N | 2080P0208X | Pediatric Infectious Diseases | 52155 | MN |
Y | 2080P0208X | Pediatric Infectious Diseases | 54652 | TN |
NPI | 1194954065 |
---|---|
Provider Name | Ritu Banerjee |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2009 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | MN |