Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 144420 | NY |
NPI | 1134147002 |
---|---|
Provider Name | Dr. Mario Flores Sabado |
First Address | Staten Island, NY 10312-2522 |
Second Address | Brooklyn, NY 11206-5317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 29/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00640102 | (05) | NY |
B19671 | (02) | NY |