Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N003508 | NY |
NPI | 1629144506 |
---|---|
Provider Name | Dr. Gary Kantrowitz |
First Address | Kew Gardens, NY 11415-2600 |
Second Address | Kew Gardens, NY 11415-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 24/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00939942 | (05) | NY |
T32167 | (02) | PA |