Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 156469 | NY |
NPI | 1235280660 |
---|---|
Provider Name | Dr. Michael Jonathan Chandler |
First Address | New York, NY 10021-8183 |
Second Address | New York, NY 10021-8183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2007 |
Last Update Date | 16/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B17892 | (02) |