Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 027987 | NY |
Y | 213EG0000X | General Practice | 027987 | NY |
NPI | 1003007931 |
---|---|
Provider Name | Dr. Ronald Allan Altman |
First Address | Staten Island, NY 10302-1446 |
Second Address | Staten Island, NY 10302-1446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 06/08/2007 |