Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 187756-1 | NY |
Y | 111NI0900X | Internist | 187756-1 | NY |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 187756-1 | NY |
NPI | 1023014974 |
---|---|
Provider Name | Dr. Adam Law |
First Address | Ithaca, NY 14850-4219 |
Second Address | Ithaca, NY 14850-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01332970 | (05) | NY |
1088 | TOTAL CARE GROUP (01) | NY |
2734852 | (05) | NY |
6591 | TOTAL CARE (01) | NY |
888009123 | EXCELLUS (01) | NY |
968698 | MVP (01) | NY |
AA1307 | (02) | NY |
DD2193 | (02) | NY |