Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 215907 | NY |
NPI | 1306998901 |
---|---|
Provider Name | Takeko Takeshige |
First Address | Wayne, NJ 07474-3514 |
Second Address | Bronx, NY 10451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 07/05/2015 |