Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N003006 | NY |
NPI | 1366488611 |
---|---|
Provider Name | Dr. Charles J Passet |
First Address | Forest Hills, NY 11375-1607 |
Second Address | Forest Hills, NY 11375-1607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 12/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00440524 | (05) | NY |
T31894 | (02) | NY |