Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N004511 | NY |
Y | 222Z00000X | Podiatrist | N004511 | NY |
NPI | 1053382838 |
---|---|
Provider Name | Dr. Robert Charles Parajon |
First Address | Poughkeepsie, NY 12524-1789 |
Second Address | Poughkeepsie, NY 12601-1173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 15/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01161077 | (05) | NY |
T39165 | (02) |