Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2156462 | NY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 215646 | NY |
NPI | 1194740977 |
---|---|
Provider Name | David V Tuckman |
First Address | Great Neck, NY 11021-5200 |
Second Address | Great Neck, NY 11021-5200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 13/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I39874 | (02) |