Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | N006962 | NY |
NPI | 1013440171 |
---|---|
Provider Name | Jared Littlejohn |
First Address | Harrison, NY 10528-1613 |
Second Address | Harrison, NY 10528-1613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 01/07/2020 |