Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X08016 | NY |
NPI | 1629165527 |
---|---|
Provider Name | Dr. David Mademann |
First Address | Windham, NY 12496-5308 |
Second Address | Catskill, NY 12414-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |