Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 256802 | NY |
NPI | 1073776183 |
---|---|
Provider Name | Dr. Gary B Deutsch |
First Address | Lake Success, NY 10042 |
Second Address | Lake Success, NY 10042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 17/06/2015 |