Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 030123 | NY |
NPI | 1003081340 |
---|---|
Provider Name | Dr. Leonard Michael Buchakjian |
First Address | Schenectady, NY 12309 |
Second Address | Schenectady, NY 12309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 28/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00585460 | (05) | NY |