Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N006122 | NY |
NPI | 1336258417 |
---|---|
Provider Name | David Gitlin |
First Address | Forest Hills, NY 11375-2722 |
Second Address | Bayside, NY 11358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
N006122 | LICENSE (01) | NY |