Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 034917 | NY |
NPI | 1013001460 |
---|---|
Provider Name | Gurinder Singh Wadhwa |
First Address | Albany, NY 12205-6433 |
Second Address | Schenectady, NY 12307-1508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 22/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00563635 | (05) | NY |