Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 205781 | NY |
NPI | 1356397244 |
---|---|
Provider Name | Mitchell I Chorost |
First Address | Port Washington, NY 11050-1054 |
Second Address | Fresh Meadows, NY 11365-1454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 30/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02280835 | (05) | NY |
4324H1 | BLUE CROSS BLUE SHIELD (01) | NY |