Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N3735 | NY |
NPI | 1093810756 |
---|---|
Provider Name | Gary L. Garbus |
First Address | Spring Valley, NY 10977-4913 |
Second Address | Spring Valley, NY 10977-4913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 01/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01062573 | (05) | NY |
T51235 | (02) | NY |