Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS022155L | PA |
NPI | 1023124047 |
---|---|
Provider Name | Dr. Elliot Ira Kahn |
First Address | York, PA 17402-4317 |
Second Address | York, PA 17402-4317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 23/08/2007 |