Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 246695 | NY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 246695 | NY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | N6259 | TX |
NPI | 1306003975 |
---|---|
Provider Name | Bryan Ding |
First Address | Garden City, NY 11530-1886 |
Second Address | Lake Success, NY 11042-1113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 19/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CQ616 | BCBS PAR NUMBER (01) | TX |