Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 128970-1 | NY |
N | 207L00000X | Anesthesiologist | 1289701 | NY |
NPI | 1013901255 |
---|---|
Provider Name | Dr. Delf O King |
First Address | Poughkeepsie, NY 12602 |
Second Address | Liberty, NY 12754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 25/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00485447 | (05) | NY |
D02317 | (02) |