Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 205096 | NY |
NPI | 1124029210 |
---|---|
Provider Name | David Y Eng |
First Address | Syracuse, NY 13203-1843 |
Second Address | Syracuse, NY 13203-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 17/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01711499 | (05) | NY |
G37425 | (02) |