Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 0101248493 | VA |
Y | 207RN0300X | Nephrologist | 262974 | NY |
N | 207RN0300X | Nephrologist | MD13489 | RI |
NPI | 1043529506 |
---|---|
Provider Name | Dr. Luiz Mauricio Kolankiewicz |
First Address | Hanover, NH 03755-3231 |
Second Address | Jersey City, NJ 07310-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2010 |
Last Update Date | 03/12/2011 |