Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 103461 | NY |
NPI | 1699863639 |
---|---|
Provider Name | Norman Joseph Pastorek |
First Address | New York, NY 10128-0535 |
Second Address | New York, NY 10128-0535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18383 | (02) |