Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N3854 | NY |
NPI | 1245232784 |
---|---|
Provider Name | Dr. Robert Califano |
First Address | Latham, NY 12110-2490 |
Second Address | Latham, NY 12110-2490 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 03/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11055 | (02) | NY |