Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | P84735 | NY |
NPI | 1033468533 |
---|---|
Provider Name | Dr. Roman Shyyan |
First Address | New York, NY 10022-1514 |
Second Address | New York, NY 10022-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2012 |
Last Update Date | 30/08/2012 |