Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 002244 | NY |
Y | 222Z00000X | Podiatrist | 002244 | NY |
N | 213EP1101X | Primary Podiatric Medicine | 002244 | NY |
NPI | 1528054376 |
---|---|
Provider Name | Dr. Jay L Duhl |
First Address | Long Beach, NY 11561-3505 |
Second Address | Long Beach, NY 11561-3505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 25/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00397571 | (05) | NY |
T50715 | (02) |