Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 258074 | NY |
Y | 207YP0228X | Pediatric Otolaryngology | 258074 | NY |
NPI | 1013905173 |
---|---|
Provider Name | Dr. Wasyl Szeremeta |
First Address | Plainview, NY 11803 |
Second Address | Plainview, NY 11803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 07/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1603609 | (05) | PA |
G38956 | (02) |