Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 047531-1 | NY |
N | 2080P0201X | Pediatric Allergist | 047531-1 | NY |
NPI | 1356337018 |
---|---|
Provider Name | Dr. Clifford Melvin Tepper |
First Address | Albany, NY 12205-5534 |
Second Address | Albany, NY 12205-5534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00528758 | (05) | NY |
B80707 | (02) | NY |