Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 161189-1 | NY |
NPI | 1063414472 |
---|---|
Provider Name | Dr. James Desemone |
First Address | Schenectady, NY 12304-1009 |
Second Address | Schenectady, NY 12308-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 03/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01647736 | (05) | NY |
D87886 | (02) | NY |