Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 210651 | NY |
NPI | 1013901842 |
---|---|
Provider Name | Matthew Nalbandian |
First Address | Old Tappan, NJ 07675-7079 |
Second Address | Old Tappan, NJ 07675-7003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 03/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01936992 | (05) | NY |
H36492 | (02) | NY |