Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 231752 | NY |
NPI | 1043259666 |
---|---|
Provider Name | Dr. Mitchell Kolker |
First Address | Tarrytown, NY 10591-5139 |
Second Address | New Windsor, NY 12553-5506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H47039 | (02) | NY |