Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 206254 | NY |
NPI | 1063445153 |
---|---|
Provider Name | Dr. Jean Futoran |
First Address | Roslyn Heights, NY 11577-0195 |
Second Address | Brooklyn, NY 11214-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 23/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06783G | GHI MEDICARE (01) | NY |
G89219 | (02) | NY |