Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 209452 | NY |
Y | 207YS0123X | Facial Plastic Surgeon | 209452 | NY |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 209452 | NY |
NPI | 1962441022 |
---|---|
Provider Name | Dr. Jeffrey Cousin |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Yonkers, NY 10701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 29/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H25335 | (02) | NY |