Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 206357 | NY |
NPI | 1144382144 |
---|---|
Provider Name | Dr. Soren Matthew White |
First Address | New York, NY 10021-5802 |
Second Address | New York, NY 10029-7404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 08/07/2007 |