Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N005777 | NY |
N | 2081S0010X | Sports Medicine | N005777 | NY |
N | 213ES0000X | Sports Medicine | N005777 | NY |
N | 213ES0131X | Foot Surgery | N005777 | NY |
NPI | 1407847627 |
---|---|
Provider Name | Dr. Michael G Szczepanski |
First Address | Brooklyn, NY 11209-3312 |
Second Address | Brooklyn, NY 11209-3312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 24/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02334123 | (05) | NY |
U90954 | (02) | NY |