Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 0 | NY |
NPI | 1013370378 |
---|---|
Provider Name | Dr. Travis R Ladner |
First Address | New York, NY 10029-6508 |
Second Address | New York, NY 10029-6508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2016 |
Last Update Date | 03/04/2016 |