Provider Demographics
NPI:1033340211
Name:MISRA, NILANJANA
Entity Type:Individual
Prefix:
First Name:NILANJANA
Middle Name:
Last Name:MISRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269-01 76TH AVE
Mailing Address - Street 2:COHEN CHILDREN'S MEDICAL CENTER
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-7350
Mailing Address - Fax:718-347-5864
Practice Address - Street 1:269-01 76TH AVE
Practice Address - Street 2:COHEN CHILDREN'S MEDICAL CENTER
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-7350
Practice Address - Fax:718-347-5864
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program