Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 005210 | NY |
Y | 111NS0005X | Chiropractic Sports Physician | 005210 | NY |
NPI | 1104009604 |
---|---|
Provider Name | Dr. Howard Klepper |
First Address | Bayside, NY 11360-1229 |
Second Address | Bayside, NY 11360-1229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2007 |
Last Update Date | 07/12/2007 |