Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 304081 | NY |
N | 207X00000X | Orthopaedic Surgeon | A165522 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 304081 | NY |
NPI | 1053722603 |
---|---|
Provider Name | Mathew Hamula |
First Address | Flushing, NY 11355-5045 |
Second Address | Flushing, NY 11355-5045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2014 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03368581 | (05) | NY |