Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | P87702 | NY |
NPI | 1811384134 |
---|---|
Provider Name | Carlos Alberto Millan Cortes |
First Address | Bronx, NY 10467-2510 |
Second Address | Bronx, NY 10467-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 24/04/2015 |