Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 197165 | NY |
NPI | 1063466316 |
---|---|
Provider Name | Craig S Osleeb |
First Address | Mount Kisco, NY 10549-3412 |
Second Address | Mount Kisco, NY 10549-3412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 03/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01512050 | (05) | NY |
F66939 | (02) | NY |