Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 132398 | NY |
NPI | 1033355607 |
---|---|
Provider Name | Dr. Louis Anthony Perrotta JR. |
First Address | Huntington, NY 11743-1334 |
Second Address | Huntington, NY 11743-1334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2008 |
Last Update Date | 14/09/2009 |