Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 301009 | NY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 301009 | NY |
NPI | 1497164354 |
---|---|
Provider Name | Dr. Vivek Dutt |
First Address | Albany, NY 12206-1048 |
Second Address | Albany, NY 12206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2014 |
Last Update Date | 31/10/2019 |