Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 248361 | NY |
N | 207R00000X | Internist | MA078857 | NJ |
N | 111NI0900X | Internist | MA078857 | NJ |
NPI | 1043200926 |
---|---|
Provider Name | Dr. Avi M Deener |
First Address | White Plains, NY 10604-2901 |
Second Address | White Plains, NY 10604-2901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 16/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I35621 | (02) |