Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 137043 | NY |
NPI | 1023202447 |
---|---|
Provider Name | Dr. Edward Mack Epstein |
First Address | Staten Island, NY 10306-3034 |
Second Address | Staten Island, NY 10305-3401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 28/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00955082 | (05) | NY |
C10085 | (02) | NY |
FE1088699 | DEA (01) | NY |