Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 286199 | NY |
NPI | 1033523303 |
---|---|
Provider Name | Dr. Jeremy Shugar |
First Address | Bronx, NY 10457-2545 |
Second Address | Bronx, NY 10457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2014 |
Last Update Date | 28/02/2018 |