Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N004896 | NY |
Y | 222Z00000X | Podiatrist | N004896 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N004896 | NY |
N | 111NR0200X | Radiology | N004896 | NY |
N | 213ER0200X | Radiology | N004896 | NY |
N | 2081S0010X | Sports Medicine | N004896 | NY |
N | 213ES0000X | Sports Medicine | N004896 | NY |
N | 213ES0131X | Foot Surgery | N004896 | NY |
NPI | 1750492773 |
---|---|
Provider Name | Dr. Jeffrey Mayer Knobel |
First Address | Brooklyn, NY 11229-1100 |
Second Address | Brooklyn, NY 11229-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 22/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01273789 | (05) | NY |
U29314 | (02) | NY |