Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 030168 | NY |
NPI | 1184843062 |
---|---|
Provider Name | Dr. Irving Golombeck |
First Address | Great Neck, NY 11021-1338 |
Second Address | Great Neck, NY 11021-1338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |