Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 142547 | NY |
NPI | 1023146925 |
---|---|
Provider Name | Dr. Jonathan Layton |
First Address | Brooklyn, NY 11215-5004 |
Second Address | Brooklyn, NY 11215-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B14694 | (02) |