Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 113841 | NY |
NPI | 1043223647 |
---|---|
Provider Name | Dr. Jose A Tejero |
First Address | Rhinebeck, NY 12572-0029 |
Second Address | Rhinebeck, NY 12572-0029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B16531 | (02) |