Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 157850 | NY |
Y | 111NI0900X | Internist | 157850 | NY |
N | 207U00000X | Nuclear Medicine Specialist | 157850 | NY |
NPI | 1528142387 |
---|---|
Provider Name | Maroun Karam |
First Address | Johnstown, NY 12095-2316 |
Second Address | Johnstown, NY 12095-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00997764 | (05) | NY |
A61484 | (02) | NY |