Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | P70736 | NY |
NPI | 1215250121 |
---|---|
Provider Name | Per David Trobisch |
First Address | New York, NY 10003-3804 |
Second Address | New York, NY 10003-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2010 |
Last Update Date | 05/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101200000 | (02) | NY |
0101200000 | (05) | NY |