Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 248275 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | 248275 | NY |
NPI | 1508025701 |
---|---|
Provider Name | Dr. Jason Brad Price |
First Address | New Hyde Park, NY 11042 |
Second Address | New Hyde Park, NY 11042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 05/11/2019 |