Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N002835 | NY |
Y | 222Z00000X | Podiatrist | N002835 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N002835 | NY |
NPI | 1225035769 |
---|---|
Provider Name | Dr. Bob S Biller |
First Address | Long Beach, NY 11561-2605 |
Second Address | Long Beach, NY 11561-2605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
397700 | (05) | NY |
T50905 | (02) | NY |