Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 130800 | NY |
N | 111NI0900X | Internist | 130800 | NY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 130800 | NY |
NPI | 1023011277 |
---|---|
Provider Name | Dr. Joseph George |
First Address | Hawthorne, NY 10532-2140 |
Second Address | New Windsor, NY 12553-4746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 16/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00242746 | (05) | NY |
060043588 | RAIL ROAD MEDICARE (01) | NY |
318303K222 | PTAN (01) | NY |
D39045 | (02) | NY |