Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 3843 | NY |
NPI | 1174092589 |
---|---|
Provider Name | Mr. Mccarthy Hanger |
First Address | New York, NY 10021-3653 |
Second Address | New York, NY 10021-3653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2018 |
Last Update Date | 14/11/2018 |