Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 1074831 | NY |
NPI | 1013930049 |
---|---|
Provider Name | Dr. Bardev Kapila |
First Address | Kingston, NY 12402 |
Second Address | Kingston, NY 12401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 17/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00554687 | (05) | NY |
047001 | MVP (01) | NY |
528065 | AETNA (01) | NY |
C11601 | (02) |