Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 1477841 | NY |
NPI | 1023037819 |
---|---|
Provider Name | Dr. William Tung |
First Address | Carmel, NY 10512-1000 |
Second Address | Carmel, NY 10512-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 30/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00903388 | (05) | NY |
B14394 | (02) | NY |