Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 238610-1 | NY |
N | 2084N0402X | Child Neurologist | TMD005190 | PA |
NPI | 1326097403 |
---|---|
Provider Name | Dr. Alexander V Rovner |
First Address | Grand Island, NY 14072-2171 |
Second Address | Grand Island, NY 14072-2171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02798570 | (05) | NY |
I73735 | (02) | NY |