Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 203544 | NY |
NPI | 1144294653 |
---|---|
Provider Name | David Shawn Becker |
First Address | New York, NY 10021-5431 |
Second Address | New York, NY 10021-5431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 09/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F39558 | (02) | NY |