Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 214445 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | 214445 | NY |
NPI | 1316035686 |
---|---|
Provider Name | Stephanie O. Zandieh |
First Address | New York, NY 10016-6004 |
Second Address | New York, NY 10016-6004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 10/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02175726 | (05) | NY |