Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 216632 | NY |
NPI | 1487749552 |
---|---|
Provider Name | Dr. Joel A Nathan |
First Address | New York, NY 10022-5403 |
Second Address | New York, NY 10022-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 13/03/2015 |