Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 97807 | NY |
N | 2080P0201X | Pediatric Allergist | 97807 | NY |
NPI | 1740347202 |
---|---|
Provider Name | Dr. Morton Max Teich |
First Address | New York, NY 10028-0209 |
Second Address | New York, NY 10028-0209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 16/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO9984 | (02) | NY |