Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | P109699 | NY |
NPI | 1073977401 |
---|---|
Provider Name | Michael Sybert |
First Address | New York, NY 10003-3804 |
Second Address | New York, NY 10003-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 06/07/2021 |