Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 236933 | NY |
NPI | 1033192216 |
---|---|
Provider Name | Mark S Driver |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Middletown, NY 10941-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 02/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I34811 | (02) | NY |