Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 129761 | NY |
NPI | 1063583730 |
---|---|
Provider Name | Dr. Simon Saada |
First Address | Brooklyn, NY 11228 |
Second Address | Brooklyn, NY 11228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 22/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00409352 | (05) | NY |
A400080284 | PTAN (01) | NY |
C08442 | (02) |