Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N0002490 | NY |
Y | 222Z00000X | Podiatrist | N0002490 | NY |
NPI | 1003945338 |
---|---|
Provider Name | Dr. Joseph Charles D'amico |
First Address | New York, NY 10019-3159 |
Second Address | New York, NY 10019-3159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P28601 | (02) | NY |