Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 159200 | NY |
Y | 111NI0900X | Internist | 159200 | NY |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 1592000 | NY |
N | 2081S0010X | Sports Medicine | 1592000 | NY |
N | 213ES0000X | Sports Medicine | 1592000 | NY |
NPI | 1275586687 |
---|---|
Provider Name | Eli Inzlicht-Sprei |
First Address | Brooklyn, NY 11230-1399 |
Second Address | Brooklyn, NY 11230-1399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 04/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00841447 | (05) | NY |
D38041 | (02) | NY |