Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 60-082840 | NY |
NPI | 1043360803 |
---|---|
Provider Name | Dr. Myron William Conovitz |
First Address | Great Neck, NY 11023-2045 |
Second Address | Great Neck, NY 11023-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B11920 | (02) | NY |