Healthcare Provider Details

I. General information

NPI: 1972693042
Provider Name (Legal Business Name): ARPITA DATTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 MELROSE AVE GROUND FLOOR
BRONX NY
10455-1180
US

IV. Provider business mailing address

1829 WILLIAMSBRIDGE RD 2ND FLOOR
BRONX NY
10461-6292
US

V. Phone/Fax

Practice location:
  • Phone: 718-292-3772
  • Fax: 718-292-3349
Mailing address:
  • Phone: 718-931-1252
  • Fax: 718-292-3349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number220218
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: