Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 172662 | NY |
NPI | 1013917400 |
---|---|
Provider Name | Mikhail Grinberg |
First Address | Brooklyn, NY 11229 |
Second Address | Brooklyn, NY 11229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 16/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01455710 | (05) | NY |
F31114 | (02) | |
F31114 | (02) | NY |