Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | $$$$$$$$$ | NY |
Y | 2080A0000X | Adolescent Medicine | 255397 | NY |
NPI | 1245491307 |
---|---|
Provider Name | Sofya Maslyanskaya |
First Address | Bronx, NY 10467 |
Second Address | Bronx, NY 10467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2008 |
Last Update Date | 25/06/2018 |