Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 067 | NY |
N | 213ES0131X | Foot Surgery | 067 | PR |
NPI | 1376760579 |
---|---|
Provider Name | Mr. Rafael J Oppenheimer |
First Address | San Juan, PR 00907 |
Second Address | San Juan, PR 00907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 01/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U62115 | (02) |