Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 202374 | NY |
NPI | 1124190517 |
---|---|
Provider Name | Dr. Gerard Devas |
First Address | Port Washington, NY 11050-3036 |
Second Address | Bronx, NY 10451-5504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |