Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 155253 | NY |
Y | 207RP1001X | Pulmonary Disease | 155253 | NY |
NPI | 1073675005 |
---|---|
Provider Name | Michael Steven Niederman |
First Address | New York, NY 10065-8722 |
Second Address | New York, NY 10065-8722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00785319 | (05) | NY |
A59894 | (02) |