Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 283045 | NY |
Y | 208600000X | Surgeon | 283045 | NY |
NPI | 1003107178 |
---|---|
Provider Name | Dr. David Radvinsky |
First Address | Teaneck, NJ 07666-4243 |
Second Address | Teaneck, NJ 07666-4243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2011 |
Last Update Date | 20/02/2019 |