Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 147500-1 | NY |
NPI | 1023003332 |
---|---|
Provider Name | Dr. John M. Quale |
First Address | Brooklyn, NY 11203-2056 |
Second Address | Brooklyn, NY 11203-2056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 10/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01906174 | (05) | NY |
G64547 | (02) | NY |