Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 235202 | NY |
NPI | 1649458241 |
---|---|
Provider Name | Dr. Konstantin Tarashansky |
First Address | Plainview, NY 11803-4966 |
Second Address | Huntington, NY 11743-4135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 21/12/2020 |