Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 002455-1 | NY |
NPI | 1164470654 |
---|---|
Provider Name | Dr. David Henry George |
First Address | New York, NY 10035-1815 |
Second Address | New York, NY 10035-1815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 02/09/2014 |