Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 207697 | NY |
NPI | 1013080738 |
---|---|
Provider Name | Juan Carlos Orozco |
First Address | Nanuet, NY 10954-5288 |
Second Address | New York, NY 10019-1147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01769635 | (05) | NY |
G58275 | (02) | NY |