Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 269241 | NY |
Y | 208600000X | Surgeon | 269241 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 269241 | NY |
N | 208200000X | Surgeon | 269241 | NY |
N | 208600000X | Surgeon | 269241 | NY |
N | 208200000X | Surgeon | 5159 | NE |
N | 208600000X | Surgeon | 5159 | NE |
NPI | 1861699506 |
---|---|
Provider Name | Prashant K Upadhyaya |
First Address | Syracuse, NY 13202-3188 |
Second Address | Syracuse, NY 13202-3188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 17/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03586041 | (05) | NY |