Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 161474 | NY |
NPI | 1134158793 |
---|---|
Provider Name | Dr. Terry Palatt |
First Address | Bay Shore, NY 11706-7381 |
Second Address | Bay Shore, NY 11706-7381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 02/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01091510 | (05) | NY |
161474 | LICENSE (01) | NY |
A61038 | (02) | NY |