Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 130202 | NY |
NPI | 1235213042 |
---|---|
Provider Name | Paul Silk |
First Address | Latham, NY 12110-2442 |
Second Address | Albany, NY 12208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 12/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00643816 | (05) | NY |
B82006 | (02) | NY |