Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 260821 | NY |
NPI | 1285891325 |
---|---|
Provider Name | Brian Untch |
First Address | New York, NY 10017-6706 |
Second Address | New York, NY 10065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 12/07/2018 |