Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 211161 | NY |
N | 2081P2900X | Pain Medicine | 211161 | NY |
N | 2081S0010X | Sports Medicine | 211161 | NY |
N | 213ES0000X | Sports Medicine | 211161 | NY |
NPI | 1457435737 |
---|---|
Provider Name | Dr. Abu Taher |
First Address | New Hyde Park, NY 11040-2412 |
Second Address | Brooklyn, NY 11203-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 14/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01879092 | (05) | NY |
G79090 | (02) | NY |