Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 146326 | NY |
NPI | 1114929585 |
---|---|
Provider Name | Oscar Horacio Irigoyen |
First Address | Philadelphia, PA 19107-5005 |
Second Address | Philadelphia, PA 19107-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00604100 | (05) | NY |
B15723 | (02) |