Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005686 | NY |
NPI | 1225078553 |
---|---|
Provider Name | Rafael Tabari |
First Address | Bronx, NY 10460-4363 |
Second Address | Bronx, NY 10460-4363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 13/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02534123 | (05) | NY |
BT7838088 | DEA NUMBER (01) | NY |
N005686 | STATE LICENSE NUMBER (01) | NY |
U98706 | (02) | NY |