Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 195770 | NY |
N | 2084V0102X | Vascular Neurology | 195770 | NY |
NPI | 1043262819 |
---|---|
Provider Name | Dr. Jonathan C Winick |
First Address | Bay Shore, NY 11706-8415 |
Second Address | Bay Shore, NY 11706-8415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01837232 | (05) | NY |
W6U281 | (02) | NY |