Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 214192 | NY |
NPI | 1043309834 |
---|---|
Provider Name | Albert Ayoub |
First Address | Brooklyn, NY 11215-3689 |
Second Address | Brooklyn, NY 11215-3689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 26/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60Z821 | (02) | NY |