Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 192199 | NY |
NPI | 1003821828 |
---|---|
Provider Name | Dr. Raymond Hinson |
First Address | Bronx, NY 10467 |
Second Address | Bronx, NY 10467 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 06/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01690115 | (05) | NY |
G36806 | (02) | NY |