Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 73-88 | NM |
NPI | 1003999210 |
---|---|
Provider Name | Dr. Stanley Zissman Berman |
First Address | Albuquerque, NM 87109-2941 |
Second Address | Albuquerque, NM 87109-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 04/08/2008 |