Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 117559 | NY |
NPI | 1841316197 |
---|---|
Provider Name | Mr. Zwi Kahanowicz |
First Address | New York, NY 10021-7369 |
Second Address | New York, NY 10021-7369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B17187 | (02) | NY |