Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X010646-1 | NY |
NPI | 1003965591 |
---|---|
Provider Name | Dr. Adam T Doan |
First Address | Ridgewood, NY 11385 |
Second Address | Ridgewood, NY 11385-5907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U97480 | (02) | NY |