Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 289095 | NY |
NPI | 1275827263 |
---|---|
Provider Name | Ogheneochuko E. Metitiri |
First Address | Mount Kisco, NY 10549-3446 |
Second Address | Poughkeepsie, NY 12601-5458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04869912 | (05) | NY |