Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | P69929 | NY |
NPI | 1144453887 |
---|---|
Provider Name | Dr. Paul Jack Karanicolas |
First Address | New York, NY 10065-7919 |
Second Address | New York, NY 10065-7919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2009 |
Last Update Date | 28/08/2009 |