Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 235926 | MA |
N | 111NI0900X | Internist | 235926 | MA |
Y | 207RH0002X | Hospice and Palliative Medicine | 247596 | NY |
NPI | 1164682811 |
---|---|
Provider Name | Fernando Kawai |
First Address | Great Neck, NY 11021-2111 |
Second Address | Flushing, NY 11355-5045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 22/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03473337 | (05) | NY |