Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT197461 | PA |
N | 208600000X | Surgeon | MT197461 | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 282375-1 | NY |
NPI | 1083932073 |
---|---|
Provider Name | Jonas Allan Nelson |
First Address | New York, NY 10065-6007 |
Second Address | New York, NY 10065-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 15/03/2019 |