Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 197044 | NY |
NPI | 1184623134 |
---|---|
Provider Name | Roger Ira Emert |
First Address | New York, NY 10022-3418 |
Second Address | New York, NY 10022-3418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 21/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01629345 | (05) | NY |
04M161 | EMPIRE BC/BS (01) | NY |
F97041 | (02) | NY |