Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 32764 | NY |
NPI | 1023008554 |
---|---|
Provider Name | Dr. Harvey Shandler |
First Address | New City, NY 10956-6110 |
Second Address | Pearl River, NY 10965-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 08/07/2007 |