Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 166013 | NY |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 166013 | NY |
NPI | 1902846579 |
---|---|
Provider Name | Cornelius R Verhoest JR. |
First Address | Mount Kisco, NY 10549-3446 |
Second Address | Poughkeepsie, NY 12601-5458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01792456 | (05) | NY |
G27292 | (02) | NY |