Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 171811-1 | NY |
NPI | 1013927235 |
---|---|
Provider Name | Dr. Howard Jay Antosofsky |
First Address | New York, NY 10016-6055 |
Second Address | New York, NY 10016-6055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |