Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 279536 | NY |
NPI | 1003174756 |
---|---|
Provider Name | Dr. Melvin Ku |
First Address | New York, NY 10025-1716 |
Second Address | New York, NY 10025-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 25/05/2015 |