Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 122512 | NY |
NPI | 1003887852 |
---|---|
Provider Name | Norbert Washington Rainford |
First Address | New City, NY 10956-7153 |
Second Address | New City, NY 10956-7153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 16/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00673923 | (05) | NY |
B13114 | (02) | NY |