Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 264537 | NY |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 264537 | NY |
NPI | 1427255876 |
---|---|
Provider Name | Dr. Jonathan Matthew Vigdorchik |
First Address | New York, NY 10021-4823 |
Second Address | New York, NY 10021-4823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 22/04/2021 |