Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 187839 | NY |
NPI | 1295749430 |
---|---|
Provider Name | Dr. Eric S Knochenhauer |
First Address | Staten Island, NY 10309-2622 |
Second Address | Staten Island, NY 10309-2622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 16/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02139540 | (05) | NY |
F84971 | (02) | NY |