Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 112231 | NY |
NPI | 1073946612 |
---|---|
Provider Name | Dr. Govindappa Rangaiah |
First Address | Scarsdale, NY 10583-7708 |
Second Address | Scarsdale, NY 10583-7708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2013 |
Last Update Date | 19/08/2013 |