Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 258253 | NY |
NPI | 1447208558 |
---|---|
Provider Name | Dr. Robert C Gensure |
First Address | Bronx, NY 10467-2403 |
Second Address | Bronx, NY 10467-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1170011 | (05) | LA |
H47439 | (02) |