Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005511 | NY |
NPI | 1205856606 |
---|---|
Provider Name | Emil Babayev |
First Address | Kew Gardens, NY 11415-1329 |
Second Address | Brooklyn, NY 11229-3103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PB755EX481 | MEDICARE (01) | NY |
U79825 | (02) |