Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 054055 | NY |
Y | 1223E0200X | Endodontist | 054055 | NY |
NPI | 1043466063 |
---|---|
Provider Name | Dr. Patrick M.t. Ngafook |
First Address | West Hempstead, NY 11552-2020 |
Second Address | New York, NY 10019-3918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2008 |
Last Update Date | 09/03/2020 |