Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005936 | NY |
NPI | 1124171806 |
---|---|
Provider Name | Dr. Ethan Joseph Ciment |
First Address | New York, NY 10011-3706 |
Second Address | New York, NY 10011-3706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 13/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V00820 | (02) | NY |