Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 039180 | NY |
NPI | 1013066521 |
---|---|
Provider Name | Gerald Herman |
First Address | New York, NY 10022-4147 |
Second Address | New York, NY 10022-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |