Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 131072 | NY |
NPI | 1023014776 |
---|---|
Provider Name | Dr. Dennis Gage |
First Address | New York, NY 10021-2805 |
Second Address | New York, NY 10021-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 07/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00580209 | (05) | NY |
C10079 | (02) | NY |