Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 294096 | NY |
NPI | 1023403839 |
---|---|
Provider Name | Mr. Jones Trevor Nauseef |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021-4872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 16/02/2021 |