Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 145337 | NY |
NPI | 1013986793 |
---|---|
Provider Name | Douglas Sepkowitz |
First Address | Brooklyn, NY 11215-3609 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 16/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00958810 | (05) | NY |
B18998 | (02) |