Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 241226 | NY |
NPI | 1013922335 |
---|---|
Provider Name | Manoj Kumar |
First Address | Cortland, NY 13045-2708 |
Second Address | Cortland, NY 13045-2708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 28/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02806619 | (05) | NY |
I60175 | (02) | NY |