Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 053714 | NY |
NPI | 1174794481 |
---|---|
Provider Name | Hugo J Acosta Garcia |
First Address | New York, NY 10022-6817 |
Second Address | New York, NY 10022-6817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2008 |
Last Update Date | 13/03/2008 |