Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 060273 | NY |
NPI | 1164755989 |
---|---|
Provider Name | Amr A Habib |
First Address | Altamont, NY 12009-2829 |
Second Address | Albany, NY 12204-3717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2009 |
Last Update Date | 20/10/2020 |