Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 257049-1 | NY |
Y | 207K00000X | Allergist & Immunologist | 56325 | MN |
NPI | 1003110008 |
---|---|
Provider Name | Alaaddin Hasan Kandeel |
First Address | Duluth, MN 55805-1951 |
Second Address | Duluth, MN 55805-1951 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2011 |
Last Update Date | 26/02/2014 |