Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 183525 | NY |
N | 207U00000X | Nuclear Medicine Specialist | 183525 | NY |
NPI | 1124099734 |
---|---|
Provider Name | Kenneth Noah Giedd |
First Address | New York, NY 10022-6474 |
Second Address | New York, NY 10003-4243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 12/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01450577 | (05) | NY |
F73614 | (02) |