Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 030741 | NY |
NPI | 1538691878 |
---|---|
Provider Name | Garth Christensen |
First Address | New York, NY 10018-7555 |
Second Address | New York, NY 10018-7555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 28/03/2017 |