Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | N3381 | NY |
N | 222Z00000X | Podiatrist | N3381 | NY |
Y | 213ES0131X | Foot Surgery | N3381 | NY |
NPI | 1043376189 |
---|---|
Provider Name | Dr. John James Hickey |
First Address | Levittown, NY 11756-1341 |
Second Address | Levittown, NY 11756-1341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2006 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00737839 | (05) | NY |
T71183 | (02) |