Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 116965 | NY |
NPI | 1053335810 |
---|---|
Provider Name | John J Ackert |
First Address | New York, NY 10016-8366 |
Second Address | New York, NY 10016-8202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 22/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B12886 | (02) | NY |