Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 202115 | NY |
Y | 207RI0011X | Interventional Cardiology | 202115 | NY |
NPI | 1114990025 |
---|---|
Provider Name | Dr. Simon K Gorwara |
First Address | Poughkeepsie, NY 12601-3923 |
Second Address | Poughkeepsie, NY 12601-3923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 09/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02154218 | (05) | NY |
H35666 | (02) | NY |