Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 184327 | NY |
NPI | 1124117650 |
---|---|
Provider Name | David John Garry |
First Address | Stony Brook, NY 11790-0988 |
Second Address | East Setauket, NY 11733-4079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 01/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01706376 | (05) | NY |
G45742 | (02) | NY |