Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N002173 | NY |
NPI | 1588705859 |
---|---|
Provider Name | Dr. Charles Edward Yasmer |
First Address | Glen Cove, NY 11542-2783 |
Second Address | Glen Cove, NY 11542-2782 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 21/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T50675 | (02) | NY |