Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 161240 | NY |
NPI | 1326049123 |
---|---|
Provider Name | David Shulan |
First Address | Albany, NY 12211-2554 |
Second Address | Albany, NY 12211-2554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00898628 | (05) | NY |
B80804 | (02) |