Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 25MD00312400 | NJ |
Y | 213ES0103X | Foot & Ankle Surgery | N006441-1 | NY |
N | 213ES0103X | Foot & Ankle Surgery | PO3520 | FL |
NPI | 1063673416 |
---|---|
Provider Name | Dr. Mario Voloshin |
First Address | Brooklyn, NY 11222-4023 |
Second Address | Brooklyn, NY 11222-4023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2008 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03493730 | (05) | NY |