Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 47922 | MN |
NPI | 1053382465 |
---|---|
Provider Name | Jason M Golbin |
First Address | Bay Shore, NY 11706-8415 |
Second Address | Bay Shore, NY 11706-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 04/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I44297 | (02) |