Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 145242 | NY |
N | 208600000X | Surgeon | 145242 | NY |
Y | 208C00000X | Colorectal Surgeon | 145242 | NY |
NPI | 1003823576 |
---|---|
Provider Name | Jeffrey W Milsom |
First Address | New York, NY 10021-4870 |
Second Address | New York, NY 10021-5304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 06/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62984 | (02) | NY |