Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 073010 | NY |
Y | 111NI0900X | Internist | 073010 | NY |
N | 207RG0300X | Geriatric Medicine | 073010 | NY |
NPI | 1043446693 |
---|---|
Provider Name | Dr. Paul B. Ross |
First Address | Great Neck, NY 11020-1230 |
Second Address | Great Neck, NY 11020-1230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 09/06/2009 |