Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 174941 | NY |
Y | 208600000X | Surgeon | 174941 | NY |
NPI | 1013081231 |
---|---|
Provider Name | Dr. Sydney George Mccalla |
First Address | Valley Stream, NY 11580-2432 |
Second Address | Bronx, NY 10451-5504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |