Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 190781 | NY |
NPI | 1245202662 |
---|---|
Provider Name | Dr. Kenneth Rivlin |
First Address | New York, NY 10162-0010 |
Second Address | New York, NY 10032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02235463 | (05) | NY |
G83393 | (02) | NY |