Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 158152 | NY |
NPI | 1215027636 |
---|---|
Provider Name | Dr. Daniel J Kenigsberg |
First Address | Avon, CT 06001 |
Second Address | Melville, NY 11747-3193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 11/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62013 | (02) | NY |