Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 276370 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 276370 | NY |
NPI | 1265729115 |
---|---|
Provider Name | David M. Whitehead |
First Address | North New Hyde Park, NY 11042-2062 |
Second Address | North New Hyde Park, NY 11042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 25/10/2019 |