Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 310268 | NY |
Y | 111NI0900X | Internist | 310268 | NY |
N | 207RH0002X | Hospice and Palliative Medicine | 310268 | NY |
NPI | 1326579830 |
---|---|
Provider Name | Paul Poidomani |
First Address | Southampton, NY 11968-4973 |
Second Address | Southampton, NY 11968-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2017 |
Last Update Date | 16/11/2021 |