Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 248268 | NY |
N | 207X00000X | Orthopaedic Surgeon | P-236524 | MA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 248268 | NY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 248268 | NY |
NPI | 1376791277 |
---|---|
Provider Name | Dr. Henock T. Wolde-Semait |
First Address | Garden City, NY 11530-1885 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D72407 | LICENSE (01) | MD |