Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 047145 | NY |
NPI | 1083821599 |
---|---|
Provider Name | Dr. Rodolfo Sanchez |
First Address | New York, NY 10155-0002 |
Second Address | New York, NY 10155-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |