Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 130912 | NY |
NPI | 1861460859 |
---|---|
Provider Name | Dr. Robert J Desnick |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B13009 | (02) | NY |