Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2029 | NY |
NPI | 1043353170 |
---|---|
Provider Name | Dr. Roy Howard Siegel |
First Address | New York, NY 10023-6629 |
Second Address | New York, NY 10023-6629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T71213 | (02) |