Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 127930 | NY |
NPI | 1043203995 |
---|---|
Provider Name | Dr. Gerald W Zaidman |
First Address | Valhalla, NY 10595 |
Second Address | Valhalla, NY 10595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00934785 | (05) | NY |
B17109 | (02) |