Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 002434 | NY |
NPI | 1063421691 |
---|---|
Provider Name | Dr. Ronen Haeem Jhirad |
First Address | Rochester, NY 14624-1119 |
Second Address | Rochester, NY 14624-1119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 05/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02693290 | (05) | NY |
I46020 | (02) | NY |