Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 271706 | NY |
NPI | 1497958060 |
---|---|
Provider Name | Jk John Kinnally Rasamny |
First Address | Ardsley, NY 10502-1045 |
Second Address | Ardsley, NY 10502-1045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 20/05/2014 |