Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 239228 | NY |
N | 207V00000X | Obstetrician & Gynecologist | 239228 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 239228 | NY |
NPI | 1639401862 |
---|---|
Provider Name | Gary Fruhman |
First Address | Staten Island, NY 10305-3436 |
Second Address | Staten Island, NY 10305-3436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2010 |
Last Update Date | 25/01/2017 |