Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 236350-1 | NY |
NPI | 1144370537 |
---|---|
Provider Name | Dr. Matthew S Traugott |
First Address | Mineola, NY 11501-2432 |
Second Address | Mineola, NY 11501-2432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |