Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N004901-1 | NY |
NPI | 1598854150 |
---|---|
Provider Name | Dr. Yahaya Nauzo |
First Address | Brooklyn, NY 11233-1804 |
Second Address | Brooklyn, NY 11233-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01340954 | (05) | NY |
U29480 | (02) | NY |