Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 119014-1 | NY |
NPI | 1043205339 |
---|---|
Provider Name | Dr. Brian J. Anziska |
First Address | Brooklyn, NY 11203-2056 |
Second Address | Brooklyn, NY 11203-2056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 29/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00222335 | (05) | NY |
B17119 | (02) | NY |