Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 211186 | NY |
NPI | 1043215320 |
---|---|
Provider Name | Dr. Alexander Marinbakh |
First Address | Brooklyn, NY 11229-2379 |
Second Address | Brooklyn, NY 11235-7900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 24/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02138801 | (05) | NY |
H30583 | (02) | NY |