Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 130751 | NY |
NPI | 1134208879 |
---|---|
Provider Name | Dr. Eric Manheimer |
First Address | New York, NY 10003-5944 |
Second Address | New York, NY 10003-5944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 12/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E12744 | (02) | NY |