Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 198140 | NY |
N | 207RG0100X | Gastroenterologist | 198140 | NY |
NPI | 1124058631 |
---|---|
Provider Name | Joseph A Odin |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 16/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02157702 | (05) | NY |
G61234 | (02) |