Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 244205 | NY |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 244205 | NY |
NPI | 1194769851 |
---|---|
Provider Name | Ross Zeltser |
First Address | Fishkill, NY 12524-1791 |
Second Address | Fishkill, NY 12524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 13/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02919717 | (05) | NY |