Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 246401-1 | NY |
NPI | 1003928441 |
---|---|
Provider Name | Nelson Barcelon |
First Address | Northport, NY 11768-2200 |
Second Address | Northport, NY 11768-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 11/04/2011 |