Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 211717 | NY |
NPI | 1053341586 |
---|---|
Provider Name | Seema Sami Rizvi |
First Address | Poughkeepsie, NY 12602-0426 |
Second Address | Fishkill, NY 12524-1634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 30/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G80402 | (02) |