Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N004702 | NY |
NPI | 1194829663 |
---|---|
Provider Name | Dr. Victor Arena |
First Address | Wantagh, NY 11793 |
Second Address | Wantagh, NY 11793 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01207616 | (05) | NY |
75564 | GHI (01) | NY |
P51992 | BC (01) | NY |
T96012 | (02) |