Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 188236 | NY |
NPI | 1003923038 |
---|---|
Provider Name | Dr. Richard E Koty |
First Address | New Hyde Park, NY 11042 |
Second Address | Port Jefferson, NY 11777-2188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 25/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01580890 | (05) | NY |
G06341 | (02) | NY |