Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 034947 | CT |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 150427 | MA |
N | 207YS0123X | Facial Plastic Surgeon | 034947 | CT |
NPI | 1700975372 |
---|---|
Provider Name | Dr. Ari Jay Namon |
First Address | Mount Kisco, NY 10549-3446 |
Second Address | Poughkeepsie, NY 12601-3906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001349473 | (05) | CT |
110039589A | (05) | MA |
F41280 | (02) | CT |