Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 259356 | NY |
N | 207X00000X | Orthopaedic Surgeon | 53196 | CT |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 259356 | NY |
NPI | 1134388697 |
---|---|
Provider Name | Dr. Samuel Taylor |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021-4823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 31/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03880504 | (05) | NY |