Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 200985-1 | NY |
NPI | 1346309549 |
---|---|
Provider Name | Dr. Robert Jonathan Kiltz |
First Address | Syracuse, NY 13205-2548 |
Second Address | Syracuse, NY 13205-2548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F46594 | (02) | NY |