Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1528021730 |
---|---|
Provider Name | Michael Shur |
First Address | Brooklyn, NY 11235-2661 |
Second Address | Brooklyn, NY 11210-2661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 13/05/2008 |