Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 291952 | NY |
Y | 111NI0900X | Internist | 291952 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 291952 | NY |
N | 208000000X | Pediatrician | 291952 | NY |
NPI | 1063505295 |
---|---|
Provider Name | Daniel Louis |
First Address | Brooklyn, NY 11212-8134 |
Second Address | Brooklyn, NY 11212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 12/07/2018 |