Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 228510 | NY |
NPI | 1063470607 |
---|---|
Provider Name | Dr. Harold John Henning JR. |
First Address | Etobicoke, ON M9C 0C1 |
Second Address | Mississauga, ON M9C 0C1 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 17/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02422159 | (05) | NY |
B69243 | (02) | NY |