Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 263103 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 263103 | NY |
NPI | 1609032101 |
---|---|
Provider Name | Vidya Krish Mony |
First Address | Brooklyn, NY 11219-2919 |
Second Address | Brooklyn, NY 11219-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 21/10/2014 |