Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 22229 | NY |
NPI | 1053501288 |
---|---|
Provider Name | Dr. Walter E Bimston |
First Address | Bronx, NY 10458 |
Second Address | Bronx, NY 10458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 25/07/2007 |