Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 212943 | NY |
Y | 207Q00000X | Family Doctor | 212943 | NY |
NPI | 1366529679 |
---|---|
Provider Name | Dr. John Battista Caramagna |
First Address | East Norwich, NY 11732-1310 |
Second Address | East Norwich, NY 11732-1310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 22/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H26433 | UPIN (01) | NY |