Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 267233 | NY |
NPI | 1144473117 |
---|---|
Provider Name | Dr. Thomas Aghahowa Imahiyerobo JR. |
First Address | New York, NY 10032-3729 |
Second Address | New York, NY 10032-3733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 09/05/2015 |