Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 1961697-7 | NY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 1961697-7 | NY |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 1961697-7 | NY |
NPI | 1457440240 |
---|---|
Provider Name | Paul P Hospodar |
First Address | Albany, NY 12206-1043 |
Second Address | Albany, NY 12206-1043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 25/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000406714003 | BS NENY (01) | NY |
01508061 | (05) | NY |
10002622 | CDPHP (01) | NY |
18300 | MVP (01) | NY |
5687263 | AETNA (01) | NY |
84G901 | EMPIRE BC (01) | NY |
F65515 | (02) |