Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 254266 | NY |
NPI | 1063643641 |
---|---|
Provider Name | Harry Pantelides |
First Address | New York, NY 10009-8925 |
Second Address | Brooklyn, NY 11211-8755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2009 |
Last Update Date | 28/09/2021 |