Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 126595 | NY |
NPI | 1023164555 |
---|---|
Provider Name | Dr. Augusto M. Miyashiro |
First Address | Brooklyn, NY 11220-5075 |
Second Address | Brooklyn, NY 11220-5075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 22/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F20551 | (02) | NY |