Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 196158 | NY |
NPI | 1205801883 |
---|---|
Provider Name | Dr. Gustavo Deltoro |
First Address | New York, NY 10021-3339 |
Second Address | New York, NY 10032-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 18/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01859365 | (05) | NY |
H76628 | (02) | NY |