Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 195459 | NY |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 195459 | NY |
NPI | 1174578132 |
---|---|
Provider Name | Dr. Paul Enker |
First Address | Great Neck, NY 11021-5323 |
Second Address | Great Neck, NY 11021-5323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01597713 | (05) | NY |
E86025 | (02) | NY |