Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 215759-2 | NY |
NPI | 1225050206 |
---|---|
Provider Name | Dr. Samuel J Beran |
First Address | White Plains, NY 10601-5112 |
Second Address | White Plains, NY 10601-5112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G49636 | (02) | NY |