Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 045029 | NY |
Y | 213EG0000X | General Practice | 045029 | NY |
NPI | 1003946815 |
---|---|
Provider Name | Dr. Felipe Santiago Vargas |
First Address | Woodhaven, NY 11421-1852 |
Second Address | Woodhaven, NY 11421-1852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01461985 | (05) | NY |
970818 | UNITED CONCORDIA (01) | NY |