Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 279639 | NY |
NPI | 1053652834 |
---|---|
Provider Name | Teja Mahadeshwar Kapoor |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2013 |
Last Update Date | 27/01/2017 |