Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 220297 | NY |
NPI | 1003839127 |
---|---|
Provider Name | Michael Ameres |
First Address | Water Mill, NY 11976-0659 |
Second Address | Southampton, NY 11968-5009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/08/2008 |