Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 267577 | NY |
Y | 207KA0200X | Allergist | 267577 | NY |
NPI | 1215358908 |
---|---|
Provider Name | Marc Braunstein |
First Address | Woodmere, NY 11598-1923 |
Second Address | Hewlett, NY 11557-1534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2013 |
Last Update Date | 09/09/2018 |