Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 135195-1 | NY |
NPI | 1205916038 |
---|---|
Provider Name | Dr. Oscar Chamudes |
First Address | Astoria, NY 11103-3952 |
Second Address | Astoria, NY 11103-3952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 02/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00298980 | (05) | NY |