Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 292021 | NY |
Y | 207RA0201X | Internist - Allergy & Immunology | 292021 | NY |
NPI | 1659786440 |
---|---|
Provider Name | Robert Tamayev |
First Address | New York, NY 10128-1049 |
Second Address | Glendale, NY 11385-7451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 04/03/2020 |