Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 275110 | NY |
NPI | 1376861765 |
---|---|
Provider Name | Gabriel Radu |
First Address | Saratoga Springs, NY 12866-2958 |
Second Address | Saratoga Springs, NY 12866-2958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 19/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03993799 | (05) | NY |