Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 2313641 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 231364 | NY |
NPI | 1174510267 |
---|---|
Provider Name | Ramon Brugada |
First Address | Syracuse, NY 13210-1892 |
Second Address | Syracuse, NY 13210-1892 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02595128 | (05) | NY |
BB8867775 | DEA (01) | NY |
H22894 | (02) |