Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N002549 | NY |
NPI | 1417917527 |
---|---|
Provider Name | Dr. Leonard Alan Rickman |
First Address | Kew Gardens, NY 11418-1017 |
Second Address | Kew Gardens, NY 11418-1017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00415729 | (05) | NY |
T32090 | (02) | NY |