Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 100016 | NY |
NPI | 1033105721 |
---|---|
Provider Name | Anis I Obeid |
First Address | Syracuse, NY 13210-1754 |
Second Address | Syracuse, NY 13210-1687 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 24/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00447190 | (05) | NY |
B79470 | (02) |