Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 309136 | NY |
NPI | 1316392418 |
---|---|
Provider Name | Dr. Christopher Michael Scanlon |
First Address | Philadelphia, PA 19107-3015 |
Second Address | New York, NY 10003-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 21/06/2021 |