Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 246389 | NY |
N | 2081P2900X | Pain Medicine | 246389 | NY |
NPI | 1043408719 |
---|---|
Provider Name | Dr. Michael Adler |
First Address | Flushing, NY 11367-3120 |
Second Address | Flushing, NY 11367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 14/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03114523 | (05) | NY |