Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N003283 | NY |
NPI | 1588613905 |
---|---|
Provider Name | Dr. Edward Charles Rzonca |
First Address | Montrose, NY 10548 |
Second Address | Montrose, NY 10548-1454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 14/03/2013 |