Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 253916 | NY |
NPI | 1376718809 |
---|---|
Provider Name | Dr. Evan Andrew Rieder |
First Address | New York, NY 10017-6739 |
Second Address | New York, NY 10017-6739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2008 |
Last Update Date | 26/03/2021 |