Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 187224 | NY |
NPI | 1003035221 |
---|---|
Provider Name | Dr. James Newell Dillard |
First Address | New York, NY 10016-5421 |
Second Address | New York, NY 10016-5421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 24/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40493 | (02) | NY |