Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 304252 | NY |
NPI | 1053790642 |
---|---|
Provider Name | John F Charitable |
First Address | Brooklyn, NY 11201-4356 |
Second Address | Brooklyn, NY 11201-4356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 07/06/2021 |