Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 106756 | NY |
NPI | 1508928938 |
---|---|
Provider Name | Jon T Toussaint |
First Address | Albany, NY 12206-1043 |
Second Address | Albany, NY 12206-1043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 20/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00503017 | (05) | NY |
10002058 | CDPHP (01) | NY |
B80863 | (02) |