Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 192662 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 192662 | NY |
NPI | 1225006182 |
---|---|
Provider Name | Desmond White |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Hawthorne, NY 10532-2140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 07/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01654824 | (05) | NY |
F87733 | (02) | NY |