Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 055284-1 | NY |
N | 204E00000X | Oral & Maxillofacial Surgeon | A63324 | CA |
NPI | 1417906777 |
---|---|
Provider Name | Dr. Brian L. Schmidt |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 29/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A633240 | (05) | CA |
H54968 | (02) | CA |