Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | FM1793505 | NY |
Y | 207KA0200X | Allergist | FM1793505 | NY |
NPI | 1326201757 |
---|---|
Provider Name | Dr. Timothy Mainardi |
First Address | New York, NY 10007-2250 |
Second Address | New York, NY 10007-2250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 05/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326201757 | NPI (01) | NY |