Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 175636 | NY |
NPI | 1558391334 |
---|---|
Provider Name | Dr. Hugh Marshall Ettlinger |
First Address | Ossining, NY 10562-1610 |
Second Address | Bronx, NY 10457-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E55969 | (02) | NY |