Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 082655-1 | NY |
NPI | 1639163223 |
---|---|
Provider Name | Eugene Garrow |
First Address | Brooklyn, NY 11203-2017 |
Second Address | Brooklyn, NY 11203-2017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02948303 | (05) | NY |
C55542 | (02) | NY |