Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 276899 | NY |
NPI | 1629337928 |
---|---|
Provider Name | Dr. Jonathan Matthew Giftos |
First Address | Brooklyn, NY 11215-4151 |
Second Address | New York, NY 10003-8908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 13/08/2020 |