Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X001932 | NY |
NPI | 1033258413 |
---|---|
Provider Name | Dr. Brian Patrick Holt |
First Address | Pearl River, NY 10965-1238 |
Second Address | Pearl River, NY 10965-1262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T51927 | (02) |