Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 206300 | NY |
NPI | 1003838343 |
---|---|
Provider Name | Dr. Daniel Mike Rothberg |
First Address | Mount Kisco, NY 10549-3446 |
Second Address | Yorktown Heights, NY 10598-4436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 11/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01947699 | (05) | NY |
G91847 | (02) | NY |