Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 000119 | NY |
N | 1223E0200X | Endodontist | 0401417396 | VA |
N | 1223E0200X | Endodontist | 37237 | TX |
N | 1223E0200X | Endodontist | AD.0000521 | CO |
NPI | 1003370750 |
---|---|
Provider Name | Pierre Louis Auguste Wohlgemuth |
First Address | Long Island City, NY 11109-5940 |
Second Address | New York, NY 10017-6739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2019 |
Last Update Date | 18/01/2022 |