Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 003330 | NY |
NPI | 1063522001 |
---|---|
Provider Name | Hiroo Takayama |
First Address | New York, NY 10087-7036 |
Second Address | New York, NY 10032-3733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 27/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3126047 | (05) | NY |