Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 251921-1 | NY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD433437 | PA |
NPI | 1619139011 |
---|---|
Provider Name | Daniel Kelmanovich |
First Address | Poughkeepsie, NY 12601-6027 |
Second Address | Poughkeepsie, NY 12601-6027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 24/02/2017 |