Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 2171091 | NY |
NPI | 1033289137 |
---|---|
Provider Name | Robert E Carlin |
First Address | Syracuse, NY 13203 |
Second Address | Syracuse, NY 13203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 18/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02083672 | (05) | NY |
E74099 | (02) |