Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 036617 | NY |
NPI | 1366538910 |
---|---|
Provider Name | Dr. Harry Dym |
First Address | Brooklyn, NY 11210-3750 |
Second Address | Brooklyn, NY 11210-3750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 27/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00956721 | (05) | NY |