Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 114229 | NY |
N | 2080A0000X | Adolescent Medicine | 114229 | NY |
NPI | 1174641336 |
---|---|
Provider Name | Dr. Jay Martin Izes |
First Address | Yonkers, NY 10701-1301 |
Second Address | Yonkers, NY 10701-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B13059 | (02) | NY |