Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 292785-1 | NY |
NPI | 1013306901 |
---|---|
Provider Name | Dr. Rodion Erenburg |
First Address | Nanuet, NY 10954-5238 |
Second Address | Airmont, NY 10952-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2015 |
Last Update Date | 09/01/2019 |