Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 207730 | NY |
NPI | 1114941127 |
---|---|
Provider Name | Dr. Joseph Thomas Sanelli |
First Address | Commack, NY 11725-3131 |
Second Address | Commack, NY 11725-3131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 28/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H20135 | (02) | NY |