Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 104800-1 | NY |
NPI | 1003832726 |
---|---|
Provider Name | Dr. Stephen Morris Adalman |
First Address | Kingston, NY 12401-4812 |
Second Address | Kingston, NY 12401-4812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 23/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00182247 | (05) | NY |
57265100 | ORIGINAL MEDICARE ID (01) | NY |
B16739 | (02) | NY |