Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 212093-1 | NY |
NPI | 1083899223 |
---|---|
Provider Name | Dr. Gary M. Brittenham |
First Address | New York, NY 10032-1559 |
Second Address | New York, NY 10032-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2008 |
Last Update Date | 07/01/2008 |