Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 206969 | NY |
NPI | 1265412886 |
---|---|
Provider Name | Dr. David Brick |
First Address | New York, NY 10011-7307 |
Second Address | New York, NY 10011-7307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 13/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02085454 | (05) | NY |
H22502 | (02) | NY |