Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 298107 | NY |
NPI | 1225447956 |
---|---|
Provider Name | Dr. Gregory Paul Siroky |
First Address | Woodside, NY 11377-3428 |
Second Address | Roslyn, NY 11576-1347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2014 |
Last Update Date | 04/08/2021 |