Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 036 095068 | IL |
Y | 207RH0003X | Hematology & Oncology | 60 263531 | NY |
NPI | 1073525598 |
---|---|
Provider Name | Dr. Koen Van Besien |
First Address | New York, NY 10022-6102 |
Second Address | New York, NY 10021-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03398203 | (05) | NY |
E45006 | (02) | IL |