Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 182236 | NY |
NPI | 1518084623 |
---|---|
Provider Name | Robert Gochman |
First Address | New Hyde Park, NY 11040 |
Second Address | New Hyde Park, NY 11040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |