Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 146984-1 | NY |
NPI | 1144248519 |
---|---|
Provider Name | Dr. Barney Softness |
First Address | New York, NY 10032-3822 |
Second Address | New York, NY 10032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 22/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00906538 | MEDICARE ID (01) | NY |
7E1861 | (05) | NY |
B15741 | (02) | NY |