Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 154995 | NY |
NPI | 1275588022 |
---|---|
Provider Name | Yashodhara Kirtane |
First Address | Rockaway Park, NY 11694-1514 |
Second Address | Rockaway Park, NY 11694-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 09/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2099733 | GHI (01) | NY |
271AU2 | BC/BS (01) | NY |
A62739 | (02) | NY |