Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 119036 | NY |
NPI | 1609874833 |
---|---|
Provider Name | Dr. Arun Kumar Bhattacharyya |
First Address | New City, NY 10956-6223 |
Second Address | West Haverstraw, NY 10993-1195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F20753 | (02) | NY |