Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 225176 | NY |
NPI | 1144233586 |
---|---|
Provider Name | Zhanna Nudelman |
First Address | Brooklyn, NY 11230-2754 |
Second Address | Brooklyn, NY 11230-2754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02439430 | (05) | NY |
H88218 | (02) | NY |