Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 040644 | NY |
Y | 213EG0000X | General Practice | 040644 | NY |
NPI | 1003931908 |
---|---|
Provider Name | Dr. Lucian Sorin Nita |
First Address | Richmond Hill, NY 11418-2512 |
Second Address | Richmond Hill, NY 11418-2512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01033807 | (05) | NY |