Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 139009 | NY |
NPI | 1003945080 |
---|---|
Provider Name | Dr. Michael J. Faust |
First Address | New York, NY 10016-0709 |
Second Address | New York, NY 10016-0709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0M0281 | HEALTHNET (01) | NY |
B78698 | (02) | NY |
EMPIRE | 86A30 (01) | NY |
NS007 | OXFORD (01) | NY |