Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 051741 | NY |
NPI | 1225136195 |
---|---|
Provider Name | Dr. Akihiko Shirakura |
First Address | Somers, NY 10589-1801 |
Second Address | Armonk, NY 10504-1830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 05/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02882442 | (05) | NY |