Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 157204 | NY |
N | 2086S0102X | Surgical Critical Care | 157204 | NY |
Y | 2086S0129X | Vascular Surgeon | 157204 | NY |
NPI | 1073693594 |
---|---|
Provider Name | Dr. Roland Royston Purcell |
First Address | Brooklyn, NY 11236-3427 |
Second Address | Brooklyn, NY 11203-2006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 03/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00968685 | (05) | NY |
A64280 | (02) | NY |