Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 171308 | NY |
NPI | 1275602146 |
---|---|
Provider Name | Andrew Nelson Kornstein |
First Address | Wilton, CT 06897-2216 |
Second Address | Wilton, CT 06897-2216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 19/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31123 | (02) |