Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 211400 | NY |
NPI | 1023022712 |
---|---|
Provider Name | Kenneth Anthony Scioscia |
First Address | New Hyde Park, NY 11042-1008 |
Second Address | New Hyde Park, NY 11042-1008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |