Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 191865 | NY |
N | 111NI0900X | Internist | 191865 | NY |
Y | 207RP1001X | Pulmonary Disease | 191865 | NY |
NPI | 1053408153 |
---|---|
Provider Name | Ronald G Crystal |
First Address | New York, NY 10021-9800 |
Second Address | New York, NY 10021-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 14/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01460493 | (05) | NY |
F71434 | (02) | NY |